Cerebrus

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MKP ANTENATAL - keywords
antenatal intracranial haemorrhage old clot * antenatal ventriculomegaly; term, first day scans, dilatation of all but the fourth ventricle suggests aqueduct stenosis haemorrhagic nature: hyperechoic, nodular ependymal lining and clot remnants scattered throughout the ventricle system; cystic changes within right parietal lobe (*) no genetic diagnosis first day CUS of two term infants with petechiae and severe thrombocytopenia (platelets < 20x109/L); in both HPA1 platelet antigen alloimmunization started in utero, with ensuing intracranial bleeding long before delivery * old clot hyperechoic ependyma v3 temporal cavitating haematoma old clot porencephalic defect antenatal unilateral hydrocephalus; term; familial epistaxis postnatal additional sonographic information (first day): old clot due to IVH and right porencephalic defect following venous infarction haemostatic screen of newborn: von Willebrand disease porencephaly clot remnants dilated v3 infant with occipital porencephaly, hydrocephalus and residual frontal clot against the ependyma; mild mental retardation and severe visual sequelae antenatal ischaemic injury to thalamus two term infants with hypertonia and lowered consciousness from birth, difficult swallowing and persistent hyperchoic changes in thalamus (from day 1) and limited T1 hypersignal in thalamus without acute diffusion restriction; negative infectious and metabolic diagnostic tests germinolysis in caudothalamic groove germinolysis in caudothalamic groove hyperechoic bilateral and symmetrical ventrolateral thalamus T1 hypersignal in ventrolateral thalamus germinolysis in caudothalamic groove questionable T1 hypersignal in ventrolateral thalamus hyperechoic bilateral and symmetrical ventrolateral and medial thalamus courtesy neonatal unit Joan de Deu, Barcelona, Spain antenatal ischaemic injury to thalamus two term infants with hypertonia and lowered consciousness from birth, difficult swallowing and persistent hyperchoic changes in thalamus (from day 1) and limited T1 hypersignal in thalamus without acute diffusion restriction; negative infectious and metabolic diagnostic tests germinolysis in caudothalamic groove germinolysis in caudothalamic groove hyperechoic bilateral and symmetrical ventrolateral thalamus hyperechoic bilateral and symmetrical ventrolateral and medial thalamus germinolysis in caudothalamic groove T1 hypersignal in ventrolateral thalamus questionable T1 hypersignal in ventrolateral thalamus courtesy neonatal unit Joan de Deu, Barcelona, Spain porencephaly no communication to ventricle presumed in utero anterior trunkal MCA stroke day 1 schizencephaly-like day 28 additional left occipital porencephalic lesion term home delivery at 27w GA; evolution from subacute infarction to porencephaly simple porencephaly multicystic encephalomalacia routine first day CUS in a ventilated 32 w GA preterm; simple porencephaly at the posterior frontal right lateral ventricle, subjacent to the rolandic area; this most likely follows in utero venous medullary infarction paraventricular porencephaly schizencephaly congenital haemorrhagic infarction leading to unilateral cerebellar hypoplasia coronal view via nuchal fontanel cisterna magna defect of right cerebellar hemisphere normal left hemisphere hyperechoic infarct margin v4 sulcus collateralis mesencephalon residual right hemisphere small hemosiderin deposition In susceptibility weighted MRI hypoplastic vermis courtesy T Mühlbacher, Berlin schizencephaly mother assaulted at 22 w gestation, infant born at 35 wks: schizencephaly, septal agenesis and extensive polymicrogyria coronal ultrasound cleft septal agenesis no communication with the ventricle axial T2 MRI cleft cleft extensive polymicrogyria multicystic encephalomalacia three monozygous twin pairs with extensive destruction of the cerebral mantle in one twin, not compatible with an arterial template cotwin normal cotwin died in utero; scans at 2 weeks of age axial T2 coronal FLAIR day 1 CUS acceptor in a twin to twin transfusion syndrome with complete cerebral destruction in the first month of life; the twin was born at 30 weeks of gestation, the donor died from complete renal necrosis; the first day CUS had only suggested flaring, suggesting the ischaemic event was recently prenatal ax T2 MRI second month hydranencephaly absent cortical mantle in ACA and MCA territories normal cerebellum and remnant basilar artery terrain of cerebrum separation at diencephalon normal cerebellum and remnant basilar artery terrain of cerebrum falx present cortical mantle absent and atrophic thalami separated axial sagittal T2 courtesy L De Vries, Utrecht parietal coronal detail frontal coronal detail frontal coronal frontal coronal hemispheres fused in spite of midline development cortical mantle present hemispheres fused aqueduct atresia semilobar holoprosencephaly thalami fused cobblestone lissencephaly (WalkerWarburg syndrome) antenatal intracranial haemorrhage due to collagen 4A mutation antenatal MRI (T2 HASTE sequence) pointing to temporal matrix haemorrhage R L ipsilateral ventricular dilatation R small left porencephaly neonatal CUS R R L clot difficult to visualise posterior fontanel coronal neonatal MRI small left porencephaly clot difficult to visualise clot easy to visualise on SWI sequences antenatal germinolysis cystic leukomalacia matrix pockets caudothalamic germinolysis lateral ventricle caudate head parafrontal germinolysis thalamus temporal germinolysis pf ct courtesy Altman & Bayer (2015) geerminolysis in parafrontal (pf) and caudothalamic (ct) areas congenital rubella syndrome, bilateral cystic caudothalamic germinolysis late preterm first day scans (dichorionic twin), left parafrontal germinolytic pseudocyst; TORCH screen negative antenatal germinolysis related to congenital cytomegalovirus infection A C B caudothalamic germinolysis temporal germinolysis D G E H F I antenatal germinolysis related to inborn error of metabolism caudothalamic germinolysis flat insular lobe peroxisomal biogenesis disorder with Zellweger phenotype large cavum septi pellucidi caudothalamic germinolysis glutaric aciduria type II pyridoxine-dependent epilepsy due to ALDH7A1 mutation large parafrontal germinolytic cysts cerebellar hypoplasia large parafrontal germinolytic cysts lenticulostriate vasculopathy arteries affected, not veins high resolution images of postnatal onset arteriopathy in a preterm infant with GMH/IVH recipient in twin to twin transfusion syndrome candelabra in parasagittal scans arteriopathy with congenital CMV infection ichtyosis/prematurity/eosinophilia antenatal brain injury in congenital heart disease enlarged ventricular and extra-cerebral CSF spaces in a term infant with double outlet right ventricle and pulmonary atresia, scanned on day 2 MRI T2 at 6 weeks ZIKA virus fetopathy with brain disruption sequence subcortical calcification skull collapse term neonate, first day scans subcortical calcification arteriopathy T1-weighted relatively normal hindbrain gradient echo T2-weighted calcified spots in striatum and subcortex ventriculomegaly, enlarged subarachnoid spaces and extensive polymicrogyria subependymal pseudocysts Aicardi-Goutières syndrome coronal parasagittal term infant with progressive microcephaly in early infancy, psychomotor retardation, spasticity, feeding problems, recurrent seizures; normal platelet count, normal liver enzymes; increased CSF lymphocytosis RNASEH28 pathogenic variant scans in the fourth month of life parasagittal bilateral but asymmetric hyperechoic changes in striatum and thalamus; hyperechoic white matter CT parasagittal doppler T1-weighted calcification in white matter, sriatum and cerebellum T1-weighted calcification of the postcentral artery T1-weighted T2-weighted pseudo-Torch 1 term infant with severe microcephaly and clinical seizures, scans in week 1 coronal T1 coronal T1 axial calcification in white matter calcification in white matter calcification in thalamus SSWI parasagittal hypoplastic corpus callosum parasagittal shrunken hyperechoic thalamus insular triangle not visualised NF1A-related disorder term infant with hydronephrosis and dysmorphic features ventriculomegaly cerebellar hypoplasia calcification in white matter courtesy S Horsch, Berlin iron-sulfur cluster assembly gene IBA57 generalized hypotonia, respiratory insufficiency, arthrogryposis, microcephaly, hyperglycinemia abnormal thick cortical plate no pontocerebellar hypoplasia ventriculomegaly ex vacuo active cortical necrosis on diffusion weighted MRI neither calcification nor haemorrhage subacute and recent cell death antenatal detection of asymmetrical cortical anomalies: closed schizencephaly near term infant calcification in an area of abnormal migration axial T2 cystic germinolysis parasagittal right ventricle out-dentation Zellweger syndrome coronal <— cystic germinolysis irregular ventricular dilatation without ballooning extensive cystic germinolysis parasagittal ADC map axial T2 <— cystic germinolysis flat insular triangles <— mild lenticulostriate arteriopathy perisylvian polymicrogyria term, hypotonia, clinical seizures, kidney cysts; homozygous mutation PEX6 gene antenatal ischaemic injury to the pons two term infants with Möbius sequence; comparison of sagittal cranial ultrasound images with axial CT and MRI images CT T1MR CT sublte calcification in the dorsal brainstem is visible on ultrasound and CT, not on MRI poor quality ultrasound scans several decades old antenatal onset injury to pallidum due to mitochondrial disorder with neonatal lactic acidosis term, heart failure, cloudy corneae term, heart failure < — high T1 signal in pallidum very hyperechoic globus pallidus hypoplastic vermis courtesy Jeroen Dudink Utrecht inborn errors of metabolism CDG syndrome non-ketotic hyperglycinaemia genetic mitochondrial disorder < — large germinolytic cyst thin splenium large pericerebellar spaces corpus callosum sunken between ventricles < — cyst < — cyst vermis hypoplasia dysgenetic (hypoplastic) corpus callosum