Abnormal or delayed development of the posterior membranous area of the brain: anatomy, ultrasound diagnosis, natural history and outcome of Blake's pouch cyst in the fetus

Paladini, D.; Quarantelli, Mario; Pastore, G.; Sorrentino, M.; Sglavo, G.; Nappi, Carmine

doi:10.1002/uog.10138

Cited by 78 publications

(72 citation statements)

References 18 publications

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“…Nonfenestration of the foramen will cause normal, transient dilatation of the primitive developing fourth ventricle in an inferior and posterior direction, and the appearance of this ballooning vesicle has been termed a Blake's pouch cyst (BPC) (discussed in more detail below, Section 3) [1]. If the cyst undergoes subsequent delayed fenestration, a mega cistern magna can result [2]. The cyst can also persist into postnatal life, termed a persistent Blake's pouch cyst.…”

Section: Brief Overview Of Fourth Ventricle Embryologymentioning

confidence: 97%

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Diagnostic imaging of posterior fossa anomalies in the fetus and neonate: part 2, posterior fossa disorders

et al. 2015

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Section: Brief Overview Of Fourth Ventricle Embryologymentioning

confidence: 97%

“…2a & b). By definition, the vermis and cerebellar hemispheres are normally formed [2,6]. Depending on the patency of the foramina of Luschka, persistent BPC can therefore present with hydrocephalus of varying severity.…”

Section: Blake's Pouch Cystmentioning

confidence: 98%

Diagnostic imaging of posterior fossa anomalies in the fetus and neonate: part 2, posterior fossa disorders

et al. 2015

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“…ECM associated with a CNS malformation typically carries the prognosis of the associated pathology, for example as in cases of the Dandy-Walker malformation, Dandy-Walker variants or Blake's pouch cysts [6,12]. ECM had previously been considered to be associated with fetal aneuploidies, with early data suggesting that this finding was associated with aneuploidy in over 50% of cases [13,14,15,16,17] and particularly with trisomy 18 [18].…”

Section: Discussionmentioning

confidence: 99%

Reassessment of the Normal Fetal Cisterna Magna during Gestation and an Alternative Approach to the Definition of Cisterna Magna Dilatation

Brown¹

2013

Fetal Diagn Ther

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Introduction: Cisterna magna (CM) measurement constitutes part of the sonographic assessment of the posterior fossa. CM enlargement (ECM) is defined as a measurement exceeding 10 mm, although it has previously been noted that the CM varies in size with gestation. Existing data do not appear to reflect observations regarding CM biometry within our population and this study was therefore undertaken in order to re-evaluate CM biometry. Materials and Methods: Data from 4,750 normal pregnancies between 15 and 32 weeks of gestation were collected and used to construct a reference range for the CM. Results: Regression analysis was used to model CM across gestational age and thereby define the upper limits for normal CM measurements across gestation. The CM increases with gestation. These data suggest that a 10-mm cut-off underestimates ECM, notably in the gestational age period below 24 weeks, whilst overestimating isolated ECM beyond this. Differences in CM measurements between genders were confirmed (p < 0.0001). Conclusions: Defining ECM based upon a cut-off of 10 mm across all gestations may be inappropriate given the variation observed with gestational age. More accurate identification of fetuses with, in particular, isolated ECM may facilitate more precise evaluation of the clinical significance of this finding.

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“…There is an inverse correlation between CRL and AMA up to a CRL of 66 mm, when the AMA disappears [6]. In contrast to the PMA, disruptions of the development of the AMA are associated with a poor prognosis [10]. For this reason, it is sad that AMA can currently not be measured accurately.…”

Section: Discussionmentioning

confidence: 99%

Reference Ranges for Transvaginal Examined Fossa Posterior Structures in Fetuses from 45 to 84 mm Crown-Rump Length

Altmann

Specht²,

Scharnreitner

et al. 2018

Gynecol Obstet Invest

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Objective: The study aimed to describe reference values for structures of the posterior fossa in fetuses with a crown-rump length (CRL) between 45 and 84 mm. Materials and Methods: This was a prospective, cross-sectional study including 216 normal appearing fetuses. In transvaginal acquired 3-dimensional volume blocks, the longest diameter of the vermis (VE), posterior membranous area (PMA), medulla-oblongata-pons angle (MOPA), diameters of the medulla oblongata (MO) and pons (PO), and the area of Blake’s pouch (BP) were measured. Polynomial or linear regression analysis were performed to calculate the mean, 5th and 95th centile according to CRL. In 20 fetuses, intra- and interobserver repeatability were calculated. Results: There is a curvilinear correlation between CRL and PO (PO [mean] = 1.3893 + 0.004356 × CRL + 0.000002610 × CRL³; SD = 1.6818 – 0.03765 × CRL + 0.000003831 × CRL³; R² = 0.489); CRL and MO (MO [mean] = 1.5959–0.001905 × CRL + 0.000003362*CRL³; SD = –0.1417 + 0.005404 × CRL + 0.0000004988 × CRL³; R² = 0.525); CRL and VE (VE [mean] = –0.3640 + 0.04302 × CRL+ 0.000001486 × CRL³; SD = 0.5854 – 0.004812 × CRL + 0.0000005896 × CRL³; R² = 0.643); CRL and PMA (PMA [mean] = 0.6901 + 0.04307 × CRL – 0.0000008459 × CRL³; SD = –0.4232 + 0.02026 × CRL – 0.000001320 × CRL³; R² = 0.272); CRL and BP (mm²; BP [mean] –12.2067 + 0.3334 × CRL – 0.00001262 × CRL³; SD = –1.6431 + 0.06380 × CRL+ 0.0000003257 × CRL³; R² = 0.289). The relation between CRL and MOPA (°) is best described by a linear regression (MOPA [mean] = 79.6332 + 0.6122 × CRL; SD = 4.8453 + 0.07333 × CRL; R² = 0.318). Conclusion: We provide reference values for anatomical structures of the posterior fossa of fetuses between 45 and 84 mm CRL. The established reference values might ease the diagnosis of fetal malformations in early pregnancy.

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Abnormal or delayed development of the posterior membranous area of the brain: anatomy, ultrasound diagnosis, natural history and outcome of Blake's pouch cyst in the fetus

Abstract: Objectives To review the normal and pathological development of the posterior membranous area (PMA) in the fetal brain, to define sonographic criteria with which to diagnose a Blake's pouch cyst (BPC)

Cited by 78 publications

References 18 publications

Diagnostic imaging of posterior fossa anomalies in the fetus and neonate: part 2, posterior fossa disorders

Diagnostic imaging of posterior fossa anomalies in the fetus and neonate: part 2, posterior fossa disorders

Reassessment of the Normal Fetal Cisterna Magna during Gestation and an Alternative Approach to the Definition of Cisterna Magna Dilatation

Reference Ranges for Transvaginal Examined Fossa Posterior Structures in Fetuses from 45 to 84 mm Crown-Rump Length

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