Search :     
Cases
2014-15-06-09 Answer to the case of the week #372 © Esetov www.TheFetus.net 

Answer to the case of the week #372

June 26, 2014 - July 10, 2014

Murad Esetov, MD, Gylnabat Bekeladze, MD, Elina Gyseinova, MD.

Private Ultrasound practice “SONO”. Dagestan State Medical of Academy, Makhachkala, Russia.

 

Case report

A 20-year-old patient (G1P0) was sent to our office at 20 weeks +5 days of gestational age. Her medical history was unremarkable. 

Transvaginal ultrasonographic examination showed following findings:
 
Overall fetal biometry was concordant with gestational age and so were cranial dimensions;
Normal septum pellucidum (3,4 mm) and corpus callosum (21 mm) were present; 
Normal lateral ventricles (7 and 7,9 mm) and the third ventricle (2 mm) were seen; 
normal tectal length, anteroposterior mesencephalic diameter and pontine diameter were found; 
Cerebellum was small (15.3 mm) without clefting between the hemispheres (single-lobed cerebellum)
Posterior part of the cerebellar vermis was not seen;
Rounded fastigial recess and absent primary cerebellar fissure were present;
No extracranial abnormalities were detected.

Diagnosis of partial rhombencephalosynapsis was made. After counseling the parents opted for the termination of the pregnancy. Autopsy was not performed. No chromosomal abnormalities were found.

Here are some of the transvaginal ultrasonographic images that we obtained.

Images 1, 2: The image 1 shows axial plane through the fetal skull at the level of normal septum pellucidum and corpus callosum; small cerebellum without normal clefting between the hemispheres and the vermis (single-lobed cerebellum) can be seen. The image 2 shows coronal scan of the fetal skull though the top of the dome-shaped cerebellum.

 

Image 3. Sagittal scan of the fetal skull showing slightly hypoechoic homogeneous cerebellum without primary fissure with hyperechoic outer contour of the cerebellum. Cerebellar vermis is not seen.



Image 4.  The image represents 3D reconstruction of the sagittal plane of the fetal skull showing small cerebellum with rounded fastigial recess, normal length of the corpus callosum (1), normal tectal length (2), anteroposterior mesencephalic diameter (3) and pontine diameter (4).  


 
Image 5.The image represents tomographic 3D reconstruction showing axial planes through the small cerebellum (C) without normal clefting between the cerebellar hemispheres and anterior part of the vermis (arrows) around the 4th ventricle (4v).


Back to case
Help Support TheFetus.net :