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一种具有枕部脑膨出样形态的新型羊膜带综合征表型:病例报告。

A new phenotype of amniotic band syndrome with occipital encephalocele-like morphology: a case report.

机构信息

Department of Neurosurgery, Kanagawa Children's Medical Center, 2-138-4, Gumyoji, Minamiku, Yokohama, Kanagawa, 232-8555, Japan.

Department of Pathology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.

出版信息

Childs Nerv Syst. 2022 Jul;38(7):1405-1408. doi: 10.1007/s00381-021-05406-2. Epub 2021 Nov 5.

Abstract

Amniotic band syndrome (ABS) is a congenital abnormality that can cause a variety of deformities. Here, we report a case of ABS in which the amniotic band adhered to the skull, causing a partial cranial defect that was difficult to differentiate from an occipital encephalocele. The mother was a 24-year-old with an unremarkable medical and family history. Ultrasonography performed at 16 weeks showed that the fetus had a membranous structure in the occipital region. Occipital encephalocele was suspected, and she underwent cesarean section at 38 weeks. A male newborn was delivered, and his left occipital skin had a defect measuring 2 cm, from which a cystic structure had prolapsed. Cranial magnetic resonance imaging showed that the cystic structure had homogeneous high signal intensity on T2-weighted images. The neonate then underwent repair of the occipital encephalocele. During the operation, the membranous structures and dura were not continuous. Histological examination revealed that the membranous structures were composed of amnion, suggesting that this was a case of ABS. ABS may present with an encephalocele-like morphology without affecting the brain tissue and meninges. If an atypical encephalocele is found after birth, examination of the placenta may be helpful for a definitive diagnosis.

摘要

羊膜带综合征(ABS)是一种先天性异常,可导致多种畸形。在此,我们报告一例 ABS 病例,羊膜带黏附于颅骨,导致部分颅骨缺损,难以与枕部脑膨出相鉴别。母亲为 24 岁,既往体健,无家族病史。孕 16 周超声检查发现胎儿枕部有膜状结构,疑诊为枕部脑膨出,孕 38 周行剖宫产术。娩出一男性新生儿,左侧枕部皮肤有一大小为 2cm 的缺损,其内有囊性结构突出。头颅磁共振成像显示,囊性结构在 T2 加权图像上呈均匀高信号强度。患儿随后行枕部脑膨出修补术。术中发现,膜状结构与硬脑膜不连续。组织学检查显示,膜状结构由羊膜组成,提示为 ABS。ABS 可能表现为类似脑膨出的形态,而不影响脑组织和脑膜。如果在出生后发现不典型脑膨出,检查胎盘可能有助于明确诊断。

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