RT Book, Section
A1 Monteagudo, Ana
A1 Pilu, Gianluigi
A1 Malinger, Gustavo
A1 Buyukkurt, Selim
A1 Jadhav, Ashwin
A2 Timor-Tritsch, Ilan E.
A2 Monteagudo, Ana
A2 Pilu, Gianluigi
A2 Malinger, Gustavo
SR Print(0)
ID 1138380083
T1 INTRAUTERINE INSULTS: FETAL STROKE AND DESTRUCTIVE PROCESSES
T2 Ultrasonography of the Prenatal Brain, 3e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071613064
LK obgyn.mhmedical.com/content.aspx?aid=1138380083
RD 2024/04/19
AB KEY  POINTSMany  congenital  anomalies  of  the  brain  do  not  derive  from  abnormal  embryogenesis  but  are  the  consequence  of  destructive  processes  that  may  occur  any  time  in  gestation,  particularly  in  the  third  trimester.Most  of  these  destructive  processes  are  the  consequence  of  vascular  accidents,  hemorrhage,  or  occlusion.  The  etiology  is  often  unknown,  but  they  may  derive  from  a  variety  of  obstetric  complications,  such  as  placental  insufficiency,  coagulation  disorders,  drug  consumption,  and  transplacental  infections.Disruptive  lesions  of  the  fetal  brain  are  clinically  important  because  they  may  have  severe  consequences,  but  they  frequently  escape  early  detection.Intracranial  hemorrhage  is  probably  the  most  common  and  therefore  the  best  known  of  all  intrauterine  disruptions  of  the  fetal  brain.  The  hemorrhage  occurs  usually  into  the  lateral  ventricles,  and  the  sonographic  pictures  change  with  time.  An  echogenic  collection  is  first  seen,  and  in  the  following  days  it  develops  into  a  complex  mass  frequently  complicated  by  severe  ventriculomegaly.Prenatal  stroke  is  considered  the  most  important  determinant  of  cystic  destruction  of  the  cortex  that,  depending  on  the  time  of  occurrence  and  the  severity,  may  result  in  a  spectrum  of  conditions,  including  porencephaly  (single  or  multiple  cysts  replacing  brain  parenchyma),  schizencephaly  (a  gray  matter–lined  cleft  in  the  cerebral  mantle  connecting  the  cavity  of  lateral  ventricles  to  the  subarachnoid  space),  and  hydranencephaly  (complete  destruction  of  the  cerebral  hemispheres).Cerebellar  lesions  are  discussed  separately  even  though  they  also  deal  with  intracranial  hemorrhage.  However,  they  deserve  more  focused  attention.