Division of Neurology, Cincinnati Children's Hospital, Cincinnati, OH, USA.
Division of Pediatric Neurology, Joe DiMaggio Children's Hospital, Hollywood, CA, USA.
J Perinatol. 2019 Aug;39(8):1072-1077. doi: 10.1038/s41372-019-0407-9. Epub 2019 Jun 18.
Fetal Magnetic Resonance Imaging (MRI) is increasingly used in prenatal evaluations.
Identify common brain malformations on fetal MRI and evaluate perinatal course.
Fetal consultations from 10/2016 to 12/2017 reviewed.
Hundred consultations were requested; 94 were completed. Findings included: posterior fossa malformations (19%), agenesis/dysgenesis of corpus callosum (15%), congenital aqueductal stenosis (CAS) (14%), ventriculomegaly (11%), isolated cortical malformations (8.5%), and holoprosencephaly (6%). Posterior fossa malformations were more likely to be associated with genetic conditions and cardiac malformations. Patients with CAS all required intensive care unit admission. Overall, few patients with congenital brain malformations required feeding or respiratory support at discharge. None had seizures as neonates except two with early epileptic encephalopathy syndromes.
Even though long term neurological prognosis is poor for many conditions including high lifetime risk of epilepsy, most are discharged with no feeding or respiratory support. Seizures are rarely seen in the neonatal period.
胎儿磁共振成像(MRI)越来越多地用于产前评估。
识别胎儿 MRI 上常见的脑畸形,并评估围产期过程。
回顾 2016 年 10 月至 2017 年 12 月的胎儿会诊。
共要求进行 100 次会诊,其中 94 次完成。结果包括:后颅窝畸形(19%)、胼胝体发育不全/发育不良(15%)、先天性导水管狭窄(14%)、脑室扩大(11%)、孤立性皮质畸形(8.5%)和全前脑(6%)。后颅窝畸形更可能与遗传条件和心脏畸形相关。所有患有 CAS 的患者均需要入住重症监护病房。总体而言,先天性脑畸形患者出院时很少需要喂养或呼吸支持。除了两名患有早期癫痫性脑病综合征的患儿外,新生儿期均无癫痫发作。
尽管许多情况下的长期神经预后较差,包括终生癫痫风险较高,但大多数患者出院时无需喂养或呼吸支持。新生儿期很少出现癫痫发作。