Transient bifrontal solitary periventricular cysts in term neonates

Abstract

We describe three children born at term investigated for neonatal seizures or transient apnoea. Cranial ultrasound and MRI unexpectedly revealed symmetrical periventricular cysts adjacent to the anterior horns. We found no evidence of prenatal viral infection, intraventricular or subependymal haemorrhage or hypoxic-ischaemic lesions. The lesions were not seen on MRI at 3 months of age, but there was no compensatory dilatation of the anterior horns nor secondary loss of white matter. The appearance and location of these transient cysts were different from those of the cystic changes which typically follow germinal matrix haemorrhage or periventricular leukomalacia. Their pathogenesis and clinical significance remain to be determined.

Newborn frontal horn cysts: cause for concern?

“…The CUS were then screened and reported for the presence of FHC. All CUS of the study population were reviewed by one radiologist (SS) to confirm and monitor the 3 Case series 11 Preterm (9) NA Normal (7) Term (2) Delayed with seizure (1) Death (1) Lost to follow-up (2) Pal et al 5 Case series 21 Preterm (20) 0.72 Normal (13) Term (1) Diplegia (3) Death (6) a Rademaker et al 6 Case series 8 Preterm (5) 0.87 Normal (6) Term (3) Death (2) Ramenghi et al 7 Case report 3 Preterm (3) NA Normal (3) Sudakoff et al 9 Case series 7 29-36 weeks 0.48 Normal (4) Hypotonia (1) Hypertonia (1) Lost to follow-up (1) Thun-Hohenstein et al 10 Case report 3 38-41 weeks NA Normal (1) Delayed (2) (17) Death (10) Abbreviations: N, number of cases; NA, not available. a Outcome data from 1 infant who died at 1.9 years was included in the analysis.…”

“…The information is based on case reports and case series. [2][3][4][5][6][7][8][9][10][11][12] Further, the use of various terminologies to describe FHC including periventricular pseudocysts or cavitations, coarctation of the lateral ventricle or connatal cyst has resulted in significant heterogeneity in the way these lesions are classified.…”

“…2,3,[5][6][7][9][10][11] FHC are usually thin-walled cysts located at the superolateral angle of the frontal horn of the lateral ventricles, 13 can be unilateral or bilateral, and vary in size, shape and number. 5 They are usually noted on the first CUS and typically disappear over the first year of life.…”

“…5 They are usually noted on the first CUS and typically disappear over the first year of life. 2,10 On histopathology, the cysts contain neuroblasts and ependymal cells without any evidence of hemorrhage or distortion of the adjacent architecture. 5 The etiology has been widely speculated varying from being a normal variant to secondary to a viral infection, chromosomal anomaly or post-ischemic or hemorrhagic event.…”

“…Similarly, the outcomes reported vary from normal neurodevelopment in the majority of the cases to muscle tone abnormalities, cerebral palsy and developmental delay with or without seizures (Table 1). 2,3,[5][6][7][9][10][11] Discordant results in the literature could be due to biases in research design such as case reports or case series, inclusion of either term or both term and preterm population in most studies, 2,3,5,6,10,12 inclusion of infants with other CUS abnormalities without a similar comparator group (controls), number of infants lost to follow-up 2 and the potential confounding effect of preterm gestation on neurodevelopment outcome. In the only case-control study published to date, Wong et al 11 compared growth and neurodevelopmental outcomes in 10 infants with and without isolated paraventricular cysts.…”