Journal
NEUROLOGICAL SCIENCES
Volume 42, Issue 12, Pages 5433-5439Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s10072-021-05221-2
Keywords
Morning glory; Anomaly; Basal encephalocele; Moyamoya; Phenotypic spectrum; OFD1; Revascularization
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Funding
- Universita degli Studi di Genova within the CRUI-CARE Agreement
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Morning glory disc anomaly, transsphenoidal cephalocele, and moyamoya vasculopathy rarely co-occur, and their pathogenesis remains unclear. A rare missense variant in the OFD1 gene was found in this case, expanding the complex phenotype of OFD1 syndrome and suggesting a possible involvement of OFD1 gene and Shh pathway in the pathogenesis of these anomalies.
Morning glory disc anomaly is a congenital abnormality of the optic disc and peripapillary retina reported as an isolated condition or associated with various anomalies, including basal encephaloceles and moyamoya vasculopathy. However, the co-occurrence of these three entities is extremely rare and the pathogenesis is still poorly understood. Moreover, data on the surgical management and long-term follow-up of the intracranial anomalies are scarce. Here, we describe the case of a 11-year-old boy with morning glory disc anomaly, transsphenoidal cephalocele, and moyamoya vasculopathy, who underwent bilateral indirect revascularization with encephalo-duro-myo-arterio-pericranio-synangiosis at the age of 2 years, and endoscopic repair of the transsphenoidal cephalocele at the age of 6 years. A rare missense variant (c.1081T>C,p.Tyr361His) was found in OFD1, a gene responsible for a X-linked ciliopathy, the oral-facial-digital syndrome type 1 (OFD1; OMIM 311200). This case expands the complex phenotype of OFD1 syndrome and suggests a possible involvement of OFD1 gene and Shh pathway in the pathogenesis of these anomalies.
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