Subependymal pseudocysts

Philippe Deblieck, MD

Schermbecker Landstr. 88a, 46485 Wesel, Germany

Case report:

This 40 year-old patient (G1P0) was seen at 30 weeks with normal first and second trimester screenings, normal karyotype and TORCH serology. There was no associated visceral or brain anomaly.

Figure 1: Sagittal scan with normal corpus callosum

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Figure 2 : Normal pericallosal vascularization

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Figure 3: Parasagittal scan and video showing the subependymal pseudocysts.

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Video:

The prevalence of congenital pseudocysts in the germinal matrix in healthy term newborns is around 1% ( Heibel et al 1993) but they can also be  observed in TORCH infections, hypoxemia and  aneuploidy. There have been many records of associated brain malformations ( Mito et al 1989 ). 

Subependymal pseudocysts was observed around the mid-second to early third trimester and represents a special antenatal variant. These cysts are better seen with ultrasound  than with MRI. They are not associated with ventriculomegaly. As an isolated finding, they have no effect on cognition and behavior (Pal et al 2001 ) as observed in our case where  the baby is doing well.

References:

-An Atlas of Neonatal Brain Sonography, P.Govaert, L.De Vries, Wiley-Blackwell 2nd Edition 2010
-Pal et al, Frontal horns thin walled cysts in preterm neonates are benign. Arch Dis Chil Fetal Neonatal Ed 85:187-193
-Mito et al, Ultrasonographical and morphological examination of subependymal cystic lesions in maturely born infants.Neuropediatrics 20: 211-14

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