Five patients with the clinical diagnosis of fetal alcohol syndrome (FAS) died at the ages of 8 and 4 months and 17, 4 and 2 days. Neuropathological examination revealed microencephalic brains in all cases, without morphological evidence of maturation delay. One of them showed agenesis of the corpus callosum and hypoplasia of the cerebellar vermis. Five of them had only small dysgenetic changes, consisting mainly of glio or glioneuronal meningeal or parenchymal heterotopias. Our findings indicate that the brain is commonly but not affected in FAS. The influence of alcohol and its metabolites, as well as undernutrition, and use of other drugs by the mothers, should be taken into account as possible etiologic factors.

Twenty‐six primary and 21 secondary microcephalics were compared on the criteria of family and birth factors and clinical examinations. The two groups were similar in respect to their birthweights and parental ages at the time of birth. The group characteristics of primary microcrphalics that appear to be useful in distinguishing them from secondary cases are: (1) consanguinity in two of 13 families, (2) significantly increased number (18.9%) of pregnancy losses, (3) almost normal conditions of gestation, delivery and postnatal periods, (4) apparent microcephaly at birth in 50%, (5) relative absence of neurological problems, (6) relatively normal developmental milestones, and (7) increased frequency of subnormal intelligence in first degree relatives.

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