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Kutuk MS, Gorkem SB, Bayram A, Doganay S, Canpolat M, Basbug M. Prenatal Diagnosis and Postnatal Outcome of Schizencephaly. J Child Neurol 2015; 30:1388-94. [PMID: 25535059 DOI: 10.1177/0883073814556312] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/29/2014] [Indexed: 11/16/2022]
Abstract
The aim of this study was to present our experience with 5 cases of fetal schizencephaly in terms of prenatal diagnostic features, and postnatal outcome. The database of prenatal diagnosis unit was searched for antenatally diagnosed cases with schizencephaly. Maternal characteristics, ultrasonography, prenatal-postnatal magnetic resonance imaging (MRI) findings, and postnatal outcome were noted. Of 5 cases, 2 had definitive prenatal diagnoses on ultrasound and 3 cases were diagnosed by fetal MRI. All cases had cerebral cortical migration anomalies including polymicrogyria, subependymal heterotopia, and lissencephaly, and 2 cases had additional extracranial malformations. Three cases showed regression of the cerebral clefts on follow-up postnatal MRIs. Three cases had moderate to severe psychomotor retardation, and 1 case needed repeated ventriculoperitoneal shunt operation due to hydrocephaly. Prenatal diagnosis of schizencephaly with ultrasonography is not straightforward and required further evaluation with fetal MRI. Additional cerebral anomalies worsen the prognosis of schizencephaly.
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Affiliation(s)
- Mehmet Serdar Kutuk
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sureyya Burcu Gorkem
- Department of Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ayse Bayram
- Department of Paediatric Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Selim Doganay
- Department of Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Canpolat
- Department of Paediatric Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mustafa Basbug
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Matsumoto T, Miyakoshi K, Fukutake M, Ochiai D, Minegishi K, Tanaka M. Intracranial sonographic features demonstrating in utero development of hemorrhagic brain damage leading to schizencephaly-associated COL4A1 mutation. J Med Ultrason (2001) 2015; 42:445-6. [PMID: 26576802 DOI: 10.1007/s10396-015-0610-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 12/24/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Tadashi Matsumoto
- Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Kei Miyakoshi
- Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Marie Fukutake
- Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Daigo Ochiai
- Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuhiro Minegishi
- Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Nabavizadeh SA, Zarnow D, Bilaniuk LT, Schwartz ES, Zimmerman RA, Vossough A. Correlation of prenatal and postnatal MRI findings in schizencephaly. AJNR Am J Neuroradiol 2014; 35:1418-24. [PMID: 24610904 DOI: 10.3174/ajnr.a3872] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Schizencephaly is a rare malformation of the brain characterized by a gray matter-lined defect extending from the pial surface to the lateral ventricles. The purpose of this study was to correlate imaging findings of schizencephaly and associated anomalies on fetal and postnatal MR imaging and assess possible changes that may occur from the prenatal-to-postnatal state. MATERIALS AND METHODS A retrospective review of subjects with schizencephaly who had both pre- and postnatal MR imaging was performed. Subject age, cleft type, number, location, and features of the defects and associated anomalies were recorded. Normalized dimensions of the defect and ipsilateral ventricle were measured and correlated to changes in the clefts between pre- and postnatal imaging. RESULTS Ten subjects with 18 clefts (8 bilateral) were included. Most defects (83%) were open on prenatal MR imaging, but 47% of those were found to have subsequently closed on postnatal imaging. Evidence of prior hemorrhage was seen in 83%. Prenatal MR imaging detected all cases of an absent septum pellucidum but detected a fraction of gross polymicrogyria and missed all cases of optic nerve hypoplasia. The normalized ipsilateral ventricular and inner and middle width dimensions of the defects were significantly decreased at postnatal imaging (P < .05). The widths of the defects, ventricular width, and presence of hemorrhage were not predictors of closure of prenatally diagnosed open defects (P > .05). CONCLUSIONS In our series, nearly half of prenatally open schizencephaly defects had closed on postnatal imaging. Prenatal MR imaging was only able to demonstrate some of the associated anomalies.
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Affiliation(s)
- S A Nabavizadeh
- From the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - D Zarnow
- From the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - L T Bilaniuk
- From the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - E S Schwartz
- From the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - R A Zimmerman
- From the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - A Vossough
- From the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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Dyson L, Carlan SJ, Busowski J, Rasmussen O. Unilateral Type II Schizencephaly. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2012. [DOI: 10.1177/8756479312440623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Schizencephaly is a rare developmental disorder of the brain that is characterized by abnormal clefts within the cerebral hemispheres. Infants with this disorder commonly have developmental delay, delay in speech and language, partial or complete paralysis, poor muscle tone, and seizures. The manifestations and severity of the disease are related to the size and location of the clefts. The authors report a case of type II (open-lipped) schizencephaly diagnosed in the second trimester by sonography. Early prenatal diagnosis of fetal type II (open-lipped) schizencephaly allows time for patient counseling and discussion of options and preparation.
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Howe DT, Rankin J, Draper ES. Schizencephaly prevalence, prenatal diagnosis and clues to etiology: a register-based study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2012; 39:75-82. [PMID: 21647999 DOI: 10.1002/uog.9069] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To establish the prevalence and antenatal diagnosis of schizencephaly in the UK. METHODS Data on schizencephaly were extracted from six regional congenital anomaly registers. RESULTS Thirty-eight cases of schizencephaly were identified in 2 567 165 livebirths and stillbirths, giving a total prevalence of 1.48/100 000 births (95% CI, 1.01-1.95). Eighteen (47% (95% CI, 31-63%)) of the 38 cases were identified antenatally. No affected fetus had an abnormal karyotype identified. A high proportion of cases of schizencephaly occurred in younger mothers: 63% were aged 24 years or less, significantly higher (P < 0.0001) than the corresponding proportion (26%) of mothers in England and Wales. The majority of cases were not identified until after 22 weeks of pregnancy. Additional anomalies associated with vascular disruption sequences were found in eight cases which had septo-optic dysplasia or absent septum pellucidum, one of which also had gastroschisis. CONCLUSIONS Schizencephaly occurs more frequently in the fetuses of younger mothers. It is often associated with septo-optic dysplasia, suggesting that the two conditions may share a common origin, arising as a result of destructive processes that cause changes in the brain which only become apparent on ultrasound in the second half of pregnancy.
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Affiliation(s)
- D T Howe
- Wessex Fetal Medicine Unit, Princess Anne Hospital, Southampton, UK.
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Pooh RK, Kurjak A. 3D and 4D sonography and magnetic resonance in the assessment of normal and abnormal CNS development: alternative or complementary. J Perinat Med 2011; 39:3-13. [PMID: 20979445 DOI: 10.1515/jpm.2010.118] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Advanced transvaginal neurosonography has revealed normal and abnormal intracranial morphology. Transvaginal three-dimensional (3D) sonography demonstrates bony structure, multiplanar analysis of inside detailed morphology, tomographic ultrasound imaging in any cutting sections, 3D sonoangiography and volume calculation of ventricles and/or intracranial lesions. Longitudinal assessment of normal and abnormal central nervous system (CNS) development is done by serial scanning. However, the transvaginal high-frequency approach has several limitations due to lack of penetration and cranial bone ossification with advanced gestational age. Magnetic resonance neuroimaging enabled observation of the whole intracranial cavity, brainstem and cortical gyral/sulcal development. On the other hand, neuro-sonography has advantages in detecting intracranial calcification, vascular abnormalities, intratumoral vascularity and bone dysplasia. Moreover, 3D ultrasound demonstrates extra CNS abnormalities, strongly associated with CNS abnormalities. Any less-invasive modalities can be used for a CNS anomaly screening scan and ultrasound is no doubt the first choice. Once CNS abnormality is suspected, it is suggested to use the different technologies according to what is looked for in each abnormal CNS case. Of course, MR and 3D ultrasound imaging should be complementary as well as alternative.
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Affiliation(s)
- Ritsuko K Pooh
- CRIFM Clinical Research Institute of Fetal Medicine PMC, Osaka, Japan.
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