We describe two cases in which delayed rotation of the cerebellar vermis simulated a Dandy-Walker malformation (DWM) on early second-trimester magnetic resonance imaging (MRI). CASE REPORT Case 1A 30-year-old pregnant woman was referred for fetal magnetic resonance imaging (MRI) at 21 + 3 weeks' gestation because of an apparently enlarged fetal cisternaCorrespondence to: Dr A. Rossi, Neuroradiology Unit, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genoa, Italy (e-mail: andrearossi@gaslini.org) Accepted: 2 October 2015 magna on ultrasound examination (Figure 1). MRI examination revealed upward rotation of the cerebellar vermis with a brainstem-vermis angle (BVA) of 28 • , defined as the angle formed between a line tangential to the dorsal part of the brainstem and a line starting from the tip of the pons and crossing the lower edge of the cerebellar vermis 1 . Morphometric measurements were obtained according to previously published methods 2 , and included the vermian anteroposterior diameter (VAPD), defined as the distance from the most posterior point of the fourth ventricle to the posterior limit of the folia in a sagittal plane, vermian height (VH), defined as the maximal distance from the culmen to the pyramidal lobule in a sagittal plane, and the transverse cerebellar diameter (TCD), defined as the largest cerebellar diameter in a coronal plane. VAPD was 5.3 mm, VH was 10.3 mm and TCD was 20.2 mm. These measurements were consistent with a mild form of vermian hypoplasia with reduced VAPD when compared to reference data 3 . The posterior fossa appeared to be mildly enlarged with a normal torcular position (Figure 2). On follow-up MRI at 28 + 3 weeks, BVA had decreased to 4 • , while VAPD had increased to 9.5 mm, VH to 14.6 mm and TCD to 32.1 mm, which corresponded to normal measurements for gestational age 4 . The birth and postnatal period were uneventful, and normal psychomotor development and neurological examination were recorded at 1 year of age. Case 2A 37-year-old pregnant woman underwent fetal MRI at 19 + 5 weeks' gestation because of suspected posterior fossa anomaly on ultrasound examination. MRI revealed upward rotation of the cerebellar vermis, with a BVA of 43 • (Figure 3). Cerebellar morphometry yielded a VAPD of 4.7 mm, a VH of 7.5 mm, and a TCD of 18.5 mm, sug-

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-Gemella morbillorum, a commensal of the oropharynx, upper respiratory, urogenital and gastrointestinal tract is rarely associated with infections in humans. However, an increasing number of infectious processes in different locations have been reported. Cerebral abscesses caused by these bacteria are extremely uncommon with only four cases previously described in the literature. We present the case of a cerebellar abscess by Gemella morbillorum in a 50 years-old man with inter-atrial communication dealt by surgical excision and antimicrobial therapy.KEY WORDS: cerebellar abscess, inter-atrial communication, Gemella. Abscesso cerebelar por Gemella morbillorum em paciente com comunicação inter-atrialRESUMO -Gemella morbillorum, uma bactéria comensal da orofaringe, vias aéreas superiores e aparelhos urogenital e gastrointestinal, raramente causa infecções em humanos. No entanto, um crescente número de processos infeciosos em diferentes localizações tem sido referido. Abcessos cerebrais provocados por esta bactéria são extremamente raros, encontrando-se apenas quatro casos previamente descritos na literatura.

We report on two Portuguese sisters with a very similar phenotype characterized by severe intellectual disability, absent speech, relative macrocephaly, coarse face, cerebellar hypotrophy, and severe ataxia. Additional common features include increased thickness of the cranial vault, delayed dental eruption, talipes equino-varus, clinodactyly, and camptodactyly of the fifth finger. The older sister has retinal dystrophy and the younger sister has short stature. Their parents are consanguineous. We suggest this condition constitutes a previously unreported autosomal recessive entity.