Case of the Week # 291

Fabrice Cuillier, MD*, Alice Bertha**

April 14, 2011 - April 28, 2011.

*  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. TORCH was negative and amniocentesis showed a normal karyotype.

The ultrasound examination revealed the following findings:

Images 1-10: 32 weeks, ultrasound images of the fetal brain.

COW_291_1(1)
COW_291_2(1)
COW_291_3(1)
COW_291_4
COW_291_5
COW_291_6
COW_291_7
COW_291_8
COW_291_9
COW_291_10

Images 11-14: MRI images, 33 weeks.

COW_291_11
COW_291_12
COW_291_13
COW_291_14

Videos 1,2: 32 weeks, ultrasound examination.

View the Answer Hide the Answer

Answer

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.

Subependymal_cyst_Fabrice_1
Subependymal_cyst_Fabrice_2

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

Subependymal_cyst_Fabrice_3
Subependymal_cyst_Fabrice_4
Subependymal_cyst_Fabrice_5
Subependymal_cyst_Fabrice_6

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

Subependymal_cyst_Fabrice_7
Subependymal_cyst_Fabrice_8
Subependymal_cyst_Fabrice_9

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

Subependymal_cyst_Fabrice11
Subependymal_cyst_Fabrice12

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.  

Subependymal_cyst_Fabrice13
Subependymal_cyst_Fabrice14

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.

Subependym_cyst_Fabrice15a
Subependym_cyst_Fabrice16b

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.

Discussion Board

Start a discussion about this case
Add to Favorites Favorite

Menu