These findings are part of a longitudinal study that is continuing to recruit patients for neuroimaging. With a larger population—on the order of 30–40 patients—researchers can start looking at the effects of age, gender, and side of the angioma along with focusing on brain regions rather than hemispheres.
Dr. Juhasz noted that once progression has started, it is not always a bad thing if the angioma destroys the affected hemisphere very, very early. “The only plausible explanation is that they undergo a reorganization to the other hemisphere.”
“We use the contralateral hemisphere assuming that it is basically a healthy, normal hemisphere. But actually in some cases where this happened very early, the other hemisphere is not just normal but I would say 'supernormal,'” he said.
Neurologists wishing to enroll their SWS patients in Dr. Juhasz's longitudinal study should contact him directly at juhasz@pet.wayne.edu
Nonsegmented T1-weighted MRI (left), gray matter mask (center), and white matter mask (right) show the same plane in the same child: The red dots delinate the 39% loss of gray and 48% loss of white matter in the right hemisphere. Photos courtesy Dr. Csaba Juhasz