Blake’s pouch cyst: Prenatal diagnosis and management

Abstract

Objective: This study aimed to present the characteristic features of 19 patients who were diagnosed as having Blake’s pouch cyst (BPC) at our center. Materials and Methods: Nineteen patients diagnosed as BPC between 2015 and 2019 were included in this retrospective study. Follow-up examinations were performed using ultrasonography (US) every three weeks up to 35 weeks of gestation. Prenatal magnetic resonance imaging (MRI) was performed at the time of diagnosis or during follow-up in 13 patients. MRI or transfontanellar US was performed to confirm the diagnosis of BPC after delivery. Karyotype results of eight patients were recorded. Results: Isolated BPC was observed in 9 (47%) patients, and associated anomalies were detected in 10 (53%) patients, including seven (36%) with the central nervous system and four (21%) with cardiac anomalies. Two fetuses had abnormal karyotype analysis as trisomy 21 and 13. The MRI report of eight patients was “differential diagnosis required for Dandy-Walker complex” and only in five (26%) patients, it was reported to be compatible with BPC. Spontaneous resolution was seen in four patients. Postnatal MRI was performed in five patients, and transfontanellar US in two patients, and all MRI and US results were consistent with BPC. During the neonatal period, abnormal neurologic development was observed in four (21%) patients, and one (5%) died. Conclusion: Although the prognosis of isolated BPC is very good with healthy neurologic development until advanced ages, death in the early neonatal period and abnormal neurologic development may be observed depending on the condition of the associated anomalies.

The hidden story of the fourth ventricular choroid plexus: the flower basket of an old anatomist…

“…In the prenatal ultrasound community, the 4V-CP entered the diagnostic arena only after the description, by Tortori-Donati et al in 1996 16 , of Blake's pouch cyst (BPC) as a pathological entity distinct from mega cisterna magna in neonates. Subsequently, BPC was also demonstrated in the fetus [17][18][19] and it was established that one of the fundamental distinctive diagnostic criteria of BPC is a normal size of the vermis, unlike that which is observed in vermian hypoplasia (VH) and Dandy-Walker malformation (DWM) 17 . However, in a small number of cases, sonographic assessment of vermian biometry is not able to differentiate between BPC and VH.…”

Prenatal characteristics and management of pregnants with fetal cerebellar malformation: 4-year single center experience

“…After diagnosing FCMs, amniocentesis and/or karyotype analysis are performed to detect congenital cardiac anomalies, other multiple anomalies and genetic etiology (9). Bahram et al (10) reported that all of these fetuses had multiple anomalies, although the termination rate was reported as 26.0% in which pregnant women with fetal cerebellar anomaly (Blake's pouch cyst).…”