Prenatal diagnosis of cerebral lesions acquired in utero and with a late appearance

Abstract

Although no precise figures are available, many congenital brain lesions arise from intrauterine disruption, frequently due to obstetric complications. The most common entities include intracranial hemorrhage, ischemic lesions, thrombosis of venous vessels and infections. Accurate prenatal diagnosis is possible in many of these cases. However, the findings may be subtle, particularly in the early stage of the disruptive process. Identification of these conditions requires therefore specific expertise, the combination of fetal neurosonography and magnetic resonance, and frequently there is a need for serial examinations. Targeted diagnostic imaging should be offered to obstetric patients with conditions predisposing to prenatal cerebral insults.

Management of Pregnancies with Confirmed Cytomegalovirus Fetal Infection

“…Picone et al [79] recently reported a case of periconceptional infection in a HIV-positive pregnant women (<6 weeks' gestation) and appearance of US abnormalities at 36 weeks. These observations probably justify a prolonged US follow-up (until delivery) even if fetal infection is diagnosed early during the pregnancy [80]. …”

Expanding Porencephalic Cysts: Prenatal Imaging and Differential Diagnosis

“…In some cases, porencephalic cyst can also be related to primitive haemorrhage, especially in patients with COL4A1 mutation [8] . Indeed, as reported in our series, these lesions are diagnosed in the second half of pregnancy, most often in the third trimester, and are not present at the time of routine ultrasound screening [9] .…”

The Normal and Pathological Fetal Brain

“…Doppler ultrasound can confi rm the presence of a turbulent fl ow within this formation (Fig. 7.122 ) (Pilu et al 1997 ;Carletti et al 2009 ). This formation may on occasion become echogenic with no vascular fl ow being found.…”