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2010-11-17-10 Answer to the case of the week #291 © Cuillier www.TheFetus.net
Answer to the case of the week #291

April 14, 2011 - April 28, 2011.

Fabrice Cuillier, MD.*, Alice Bertha **

*  Service de Gynécologie-Obstétrique, Hôpital Félix Guyon, Saint-Denis de La Réunion, France.
** Student, Arizona State University. University Drive and Mill Avenue Tempe, Arizona, USA.


Case report

A healthy woman, G2 P1, was referred to our antenatal unit at 32 weeks of her uncomplicated pregnancy.
The ultrasound examination showed bilateral cyst located along the frontal horns of the lateral ventricles. Lateral ventricles measured 7 mm in width. The corpus callosum was present but seemed thin.
Serological testing for TORCH was negative. Amniocentesis showed normal karyotype.
The fetal MRI examination confirmed the ultrasound findings. The frontal horns of the lateral ventricles appeared dilated. Axial, parasagittal and coronal views showed bilateral cyst located lateral to the frontal horns of the lateral ventricles.
There were no other brain anomalies described on the MRI.
Our diagnosis based on the ultrasound and MRI findings was subependymal pseudocysts.
 
Birth weight was 2200 grams. The brains scan performed on the day 4 confirmed subependymal pseudocysts or periventricular pseudocyst. The corpus callosum was thin. There were no other associated anomalies. Baby is six months old at the moment and is doing fine.
 
Images 1,2: Sagittal view of the brain showing corpus callosum. Image 2 shows an axial view, the cavum septum pellucidum is enlarged, subependymal cysts (*) are on both sides along the cavum.



Images 3-6
: Axial view, enlarged cavum septum pellucidum and subependymal cysts.




Images 7-9: Parasagittal view of the lateral ventricle.




Image 10,11: Image 10 shows corpus callosum. Image 11 shows pericallosal artery.



Images 12,13
: MRI images; image 12 shows sagittal view of the brain. Image 13 shows a coronal view of the brain with subependymal cysts lateral to the frontal horns of the lateral ventricle.  



Images 14,15: Axial and coronal view of the brain with bilateral subependymal cysts (black arrow) leteral to the frontal horns of the lateral ventricles.



Videos 1,2
: 32 weeks, sagittal and parasagittal views of the brain showing the lateral ventricles and subependymal cyst which is located lateral to the ventricle.





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