Microcephaly

Fabrice Cuillier, MD*, C Soler, MD**, JL Alessandri, MD***, G Pastural, MD***

* Department of Gynecology, Felix Guyon Hospital, 97400 Saint- Denis, Reunion Islands, France; tel.: 0262 90 55 22; fax: 0262 90 77 30;
** Gynecologist, Joanne D' Arc clinic, 97400 Le Port, Reunion Islands, France;
*** Department of Neonatology, Hospital Felix Guyon, 97400 Saint-Denis, Reunion Islands, France;
**** Department of Obstetric, Hospital Intercommunal de Saint Benoit, Reunion Islands, France.

Case report

A 22-year-old G1P0 was referred to our clinic for a targeted examination due to of a small fetal head size detected at 30th week of gestation. During the third trimester the cerebral biometry failed to follow its percentile. The facial profile was abnormal (see images 1A, 1B, 1C, 2A, 2B). The lateral cerebral ventricles were normal. The frontal lobe seemed hypoplastic (image 2C). A sloping forehead was also present. A prenatal MRI was refused by the parents.

A male fetus was delivered at 37th week of gestation (2200 g). The diagnosis of microcephaly was confirmed. The fetal karyotype was normal and mother"s TORCH and Chikungunya screening were normal too. A postnatal MRI confirmed microcephaly, with normal subdural spaces and brain hypoplasia with diffuse cortical atrophy.

One year and 18 month later the baby shows signs of mild developmental retardation.

Images 1A, 1B: 3D images; 30th week of gestation - abnormal fetal profile with slanting forehead.

1A
1B

Images 1C: 3D images; 30th week of gestation - fetal face.

1C

Images 2A, 2B: 2D images; 30th week of gestation - abnormal fetal profile with slanting forehead.

2A
2C

Images 2C: 2D image; 30th week of gestation - dolichocephaly.

3

Images 4: Postnatal appearance of the baby with slanting forehead and decreased size of the neurocranial part of the skull.

4
 

Images 5A, 5B: Postnatal MRI of the fetal brain.

5B
5C

Images 5D: Postnatal MRI of the fetal brain.

5D

 

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