Ghazala Shahzad, Aashfa Hasan Shaikh, Vashdev Khimani, Peer Asad Aziz, Zeeshan Nasir, Pir Abdul Ahad.
Incidental pathologies on magnetic resonance imaging in delayed milestones pediatric patients.
Int J Endorsing Health Sci Res Jan ;9(1):118-23.

Background: Delayed in achieving milestones is a rare but still devastating effect with a vast amount of etiologies resides in it. At least 89% of patients with development delay showed additional clinical features. One of the best techniques used to investigate such patients is Magnetic Resonance Imaging (MRI). MRI helps in the early diagnosis of children`s delayed milestones that helps for parental counselling and identifies any recurrence risk in patients` siblings. The study aims to identify the incidental pathologies on MRI in patients with developmental delay. Methodology: It is a cross-sectional study of MRI that includes 22 patients diagnosed with additional clinical features associated with developmental delay. All the patients enrolled in the study were recruited from Liaquat University Hospital Jamshoro and Hyderabad, developing decay for six months from January 2019 to June 2019. History and clinical examination with MRI of the included study participants were made on GE 1.5 Tesla with appropriate sequence after sedation. Various anatomical structures like ventricles, corpus Collosum etc., were further examined systematically. Results: A total of 22 patients were enrolled in the study, including 11 male and 11 female. MRI findings suggest that most of the presentations, i.e. 45.5% in the study, were around 2-5 years. Furthermore, mostly founded incidental pathologies were atrophic brain (13.6%), enlarged arachnoid Space (13.6%) and Sinusitis (13.6%). Besides this, Canavan Disease and sigmoid sinus thrombosis were found together. MRI scans suggest that sinusitis usually involved mastoid antrum most often and, in some cases, it is found together with a subdural hematoma and mucosal enlargement. Conclusion: In conclusion, MRI findings in delayed milestones patient's show atrophic brain (13.6%), enlarged arachnoid spaces (13.6%) and sinusitis (13.6%). All these are not uncommon pathologies that can be the inductive factor for the pathogenesis of delayed milestone brains. This suggests that further cross-sectional studies are required to develop the findings associated with clinical features regarding incidental pathologies in developmental delay in pediatric patients.

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