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2015-04-20-22 Answer to the case of the week #394 © Qurban 

Answer to the case of the week #394

May 07, 2015 - May 21, 2015

Aasia Qurban, MD.



Case report

Following images and videos show a case of hemimegalencephaly that was observed in a 33 weeks old fetus of a 20-year old primigravida. Interventricular cardiac septum was thickened with suspected cardiac rhabdomyomas within cardiac apex - tuberous sclerosis and aortic coarctation were hypothesized. The baby was born in another hospital at 36 weeks and has died 4 days after delivery. The exact cause of newborn's demise is not known. 

Images 1-5 and video 1: The images and video show transverse scans of the fetal head with striking enlargement of the hemicerebrum - hemimegalencephaly.




Images 6-13 and video 2: The images and video shows color Doppler scans of the fetal brain with very low impedance within the vessels of the enlarged hemicerebrum. 





Images 14, 15, 16: Enlarged interventricular septum of the heart and thin left outflow tract in comparison with the enlarged right outflow tract was present. Cardiac rhabdomyoma was suspected within the cardiac apex (arrows in the image 16).


Image 17: Fetal biometry

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