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Hypothalamic Hamartoma-MRI

26 yrs old  lady  with seizures shows a well defined iso-intense to grey matter on all sequences nodular  lesion in the tuber cinereum suggesting hamartoma 

Teaching points by Dr MGK Murthy, Mr Samuel

1. Tuber cinereum  a component of Hypothalamus ,is  a hollow eminence of grey matter between optic chasm and mammillary bodies  with tuber nucleus and tubero mammillary nucleus (Produces Histamine in the brain) as constituents , serving to maintain Circadian Rhythm

2. Hamartoma  (benign non neoplastic proliferating cells ) can produce gelastic (gelos= laugh) seizures and precocious puberty 

3. MR delineates the lesion well with anterior border as lamina terminals and lateral as Anterior perforated substance , with stalk extending from it to the pituitary 

4. Contrast  study  though is suggested to exclude hypothalamic Glioma (Differential diagnosis), does not show enhancement 

4. Associated anomalies  like Anal atresia, renal anomaly (like horseshoe),polydactyly, bifid epiglottis   is known as Pallister-Hall syndrome

Hypothalamic Hamartoma-MRI Reviewed by Sumer Sethi on Tuesday, April 28, 2015 Rating: 5

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