Hydrocephalus, agenesis of the corpus callosum

Frantisek Grochal, MD

* Femicare, s.r.o., Center of prenatal ultrasonographic diagnostics, Martin, Slovak republic. UVN SNP Ruzomberok, Gynecological and obstetrical department. Catholic University in Ruzomberok, Faculty of Health Care, Ruzomberok, Slovak Republic.

Case report

A 27-year-old woman (G1P0) with non-contributive history was sent to our office at 31 weeks gestational age. Her previous examinations were reported to be normal.

Our examination revealed dilated lateral cerebral ventricles, absent cavum septum pellucidum, agenesis of the corpus callosum, aberrant course of the pericallosal artery, falx cerebri reaching the roof of the slightly dilated third cerebral ventricle, disproportion of the cardiac ventricles with dominant right ventricle and smaller left ventricle with pericardial effusion (a more precise investigation of the heart was not possible due to inconvenient position of the fetal thorax). Intrauterine growth restriction was also noted - biometry of the femurs and humeri corresponded just to 27 weeks, fetal abdomen corresponded to 29 weeks + 3 days, but biometry of the head was slightly increased, and corresponded to 30 (OFD) and 32 (BPD) weeks of gestation.

The female newborn was delivered at term and died three weeks later due to cardiac failure. Postnatal examination confirmed the findings, and consequent karyotyping revealed Turner syndrome (45X0).

We do not have pathological report to our disposal to confirm that, but the disproportion of the cardiac ventricle could be a cause of aortic coarctation which is often seen in cases of the Turner syndrome.

Images 1, 2: 31 weeks gestational age; images show transverse scans of the fetal head with striking dilatation of the lateral ventricles (the width of the lateral ventricle is measured on the image 2 - 25.2 mm).

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Images 3, 4: 31 weeks gestational age; images show coronal scans of the fetal head with falx cerebri reaching the roof of the third ventricle (arrow on the image 4).

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Images 5, 6: 31 weeks gestational age; Image 5 shows sagittal scan of the fetal head with aberrant course of the pericallosal artery (corpus callosum was not present); Image 6 shows transverse scan of the fetal head at the level of the cerebellum and cisterna magna which are normally formed.

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Images 7, 8: 31 weeks gestational age; Images show transverse scan of the fetal head using 3D glass body mode. Normally formed circle of Willis and dilated lateral ventricles can be seen.

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Images 7, 8: 31 weeks gestational age; Images show transverse scan of the fetal head using 3D inversion mode. The dilated ventricles are depicted in blue color.

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Videos 1, 2: 31 weeks gestational age; Videos show rotational sequences of the isolated dilated lateral ventricles of the brain depicted in 3D inversion mode.



Images 9, 10: 31 weeks gestational age; Images show transverse scan of the fetal head using 3D inversion mode (image 9) and SonoAVC volume calculation of the dilated lateral ventricles (image 10 - left lateral ventricle 24.3 cm3 - in red color; right lateral ventricle 35.3 cm3 - blue color).

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Images 11, 12: 31 weeks gestational age; transverse scans of the fetal thorax at the level of the four chamber view of the heart. Pericardial effusion (depicted in green color on the image 12) and disproportion of the cardiac ventricles (asterisk is placed in the smaller left ventricle on the image 12). Right cardiac wall is thickened.

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