Brain perfusion SPECT and MRI in foetal alcohol syndrome

Six boys and five girls with a mean age of 8.6 (range 3 to 13) years with f oetal alcohol syndrome (FAS) were studied by MRI and single photon emission computed tomography (SPECT) to find specific areas of vulnerability. Morph ological anomalies shown in six of 11 patients by MRI were situated both co rtically and subcortically: cortical atrophy (N=2), dilated ventricle (N=1) , corpus callosum hypoplasia (N=1), cerebellar atrophy (N=2), one of the la tter with Arnold-Chiari malformation (N=1). Delayed myelination of the whit e matter was seen in two patients. Volumetric studies of the hippocampus sh owed morphological left-right asymmetry in five of eight patients. However, SPECT showed mild hypoperfusion of the left hemisphere in all 10 subjects. The negative left-right index was located especially in the left parietooc cipital region, i.e. in the brain areas implicated in arithmetical and logi cal-grammatical functions, which are known to be affected in FAS. Normal le ft-right dominance was also lacking in the frontal area, i.e. the brain are a affected in attention-deficit-hyperactivity disorder (ADHD). Detection of these abnormalities, although they are not unique to FAS, may be helpful i n the diagnosis and any attempts at rehabilitation. Diverse morphological a nd functional abnormalities are more frequent than has usually been believe d even in less impaired children with FAS.