Differential Diagnosis of Intracranial Anomalies

The sonographic differentiation between hydranencephaly, severe hydrocephalus, and holoprosencephaly can be difficult. Careful examination of cranial anatomy has proven quite useful in differentiating these three anomalies. The presence or absence of a complete midline falx, cortical tissue, facial and cardiac anomalies, internal carotid arteries, and fetal circle of Willis is useful in providing accurate diagnoses. This case reports a failure to recognize hydrocephalus despite the presence of well-established identifiers.

Sonographic Detection of Holoprosencephaly With Cyclopia and Proboscis

The incidence of holoprosencephaly is about 1 in 10,000 to 20,000 births. There are three major forms: alobar, semilobar, and lobar. The alobar form with cyclopia is very rare. The author describes a transabdominal sonographic diagnosis of an alobar form of holoprosencephaly at 20 weeks’ gestational age. The fetus presented with cyclopia, proboscis, absence of ears and nose, polydactyly, hydrocephalus, macrocephaly, and polyhydramnios. After counseling, termination of pregnancy was performed. Two years later, a subsequent pregnancy was normal.