Responding to the positive feedback to the First Edition of our book we decided to update it and expand its content. An additional reason for this decision was the amount of new and pertinent articles which have accumulated in the last 3–4 years. We wanted to review them and add most of them to the more than 1100 references we used in the First Edition.
As far as the chapters are concerned, every previously written chapter was updated and there are several new chapters. Major changes were made in Chapters 2, 4, 5 and 8 to reflect the new clinical experience in the field of fetal neuroscan and fetal neuro-MRI. New sonographic images of commonly encountered entities were added to the previously published ones. Several rarely seen fetal neuropathologies were also illustrated and were included. All chapters were updated with the newest articles from the literature to justify the term “reference textbook,” a term used by many as they mention the First Edition of the book.
Two new chapters (9 and 14) were added dealing with three-dimensional fetal and neonatal neuroscans. Pediatric neurologists and neurosurgeons rely on neonatal CT and MRI images to study the neonatal brain. So far they seemed hesitant to counsel and to plan postnatal (and prenatal) management of pathologies based upon prenatal ultrasound imaging studies. The reason was the prenatal images were obtained at planes unfamiliar to them. They were waiting to see the postnatal imaging studies. Since the introduction of 2D and now 3D transfontanelle fetal neuroimaging by high-frequency, high-resolution ultrasound clear images can be generated in the planes which are familiar to pediatric neurologists and neurosurgeons. The expected result of these images is a better understanding of the pathologies leading to an earlier prenatal counseling and planning for postpartum management before the neonatal studies are available. We predict that the 3D fetal and neonatal brain scan will expand and will be widely employed as effective diagnostic means.
The addition of two new chapters deals with devastating diseases of the fetal brain and attempts for their correction. Chapter 16 summarizes possible causes of cerebral palsy and Chapter 18 is a description of attempts to correct neurological pathologies in utero. It seems that after the well-known moratorium to treat diseases of the brain, while the fetus is still in the womb, there may be a place for intrauterine treatment for a well-selected patient population after adequately researched surgical procedures.
The use of the icons at the side of ultrasound images, to indicate the particular plane or section at which the image was generated, was extended to several more chapters. This ensures a better understanding of the anatomy depicted.
We tried (quite successfully) to standardize the anatomic nomenclature throughout the book and based it on the latest issue of the internationally accepted Nomina Anatomica. Correctly or incorrectly, some terms are so deeply “embedded” in the daily use, that it may be impossible to constantly correct them. One such example is the word “hydrocephaly” (the accepted, correct way to use it) which over time was changed to “hydrocephalus” and (probably incorrectly) used in many publications. We selected to use the correct term “hydrocephalus” in all chapters.
We hope that the Second Edition of this book will contribute to the understanding and most importantly the earliest possible detection of neurological diseases of the fetus and the newborn.
Ilan E. Timor-Tritsch, MD
Ana Monteagudo, MD
Harris L. Cohen, MD