Asymptomatic Interhypothalamic Adhesions in Children

Abstract

With the use of high-resolution MR imaging techniques, we have increasingly observed anomalies of the hypothalamus characterized by a band of tissue spanning the third ventricle between the hypothalami, often without associated clinical sequelae. Historically, hypothalamic anomalies are highly associated with symptoms referable to a hypothalamic hamartoma, midline congenital disorder, hypothalamic-pituitary dysfunction, or seizures, with very few asymptomatic patients reported. The interhypothalamic tissue described in our cohort was observed incidentally through the routine acquisition of high-resolution T1WI. No referable symptoms were identified in most of the study group. In the appropriate patient population in which associated symptoms are absent, the described hypothalamic anomalies may be incidental and should not be misdiagnosed as hypothalamic hamartomas.

Fig 1.

A band of tissue spanning the anterior recess of the third ventricle that appeared linear in the axial and coronal planes and nodular in the sagittal plane as seen on 3T T1WI. A and B, A flat band of tissue behind the lamina terminalis. C and D, A flat band of tissue above the tuber cinereum. E and F, A nodular band of tissue contacting both lamina terminalis and tuber cinereum.

Fig 2.

Position maps of the interhypothalamic adhesions. A, All IHAs in our study. B, Asymptomatic IHAs. C, Symptomatic IHAs.