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2004-09-22-15 Answer to the Case of the week #135 © Manohar

Case of the week #135

January 14-27, 2005

S. Manohar, MD, DMRD
Madurai, India 

These are serial sonograms done on a woman who is G2,P0 and has a bad obstetric history. Her first child was diagnosed with Dandy walker cyst in the second trimester and an elective termination was done. The present scans were obtained at 19 and 21 weeks of gestational age.

Scan at 19 weeks of gestational age shows the following features:

Normal spine with no open neural tube defects and no facial dysmorphic features:

Mild ventriculomegaly:

Follow up scan at 21 weeks of gestational age demonstrates: Mild ventriculomegaly:


BPD plane and coronal plane: cavum septum pellucidum seen in the coronal plane

Surface rendered images show no facial dysmorphism.

These initial images revealed only mild dilatation of posterior horn of the lateral ventricle. Partial agenesis of the corpus callosum was suspected.

Scans done at 24 weeks of gestation:

Scan though posterior fossa resembling the face of puppy dog, the snout- is the fourth ventricle and the eyes posterior horn of lateral ventricle:

All the above images showed smooth contours of cerebrum with absence of gyri and sulci, prominent subarachnoid space and dilated lateral ventricles. These features were highly suggestive of classical Lissencephaly. An elective termination was done and the patient declined any further workup.

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