Prenatal-postnatal correlations of brain abnormalities: How lesions and diagnoses change over time

Abstract

A combination of prenatal ultrasound and MRI can be used to detect and characterize many primary and secondary CNS abnormalities in the developing fetus. While this information is useful in prenatal patient counseling, it is important to understand the factors that can influence change in diagnosis and prognosis over time. The etiology of the abnormality, the conspicuity of associated findings, the change in appearance over time, and the opinion of subspecialty experts all can influence the diagnosis. Additionally, technical factors of imaging acquisition may allow the detection of an abnormality in the postnatal period and not prenatally. Having an understanding of the normal fetal central nervous system anatomy at varying gestational ages will aid in the imaging detection and interpretation of CNS pathology. Understanding how these appearances and diagnoses can change over time will aid in the discussion of prognosis with expectant parents, which is crucial in fetal CNS abnormalities.

Abnormalities of the corpus callosum. Can prenatal imaging predict the genetic status? Correlations between imaging phenotype and genotype

“…The latter limitation is mainly related to the multicenter and retrospective design of the study. In the literature, several articles have focused on such correlations 48–51 . Regarding the CC, some discrepancies have been underlined with agenesis being sometimes missed 49,50 or irregularity of the CC being described prenatally and not found on postnatal MRI in one case.…”

Counseling for Fetal Central Nervous System Defects

“…Prenatal surgical repair of the spinal defects have recently gained prominence, with the MOMS trial reporting significant benefit in terms of motor abilities and reduction in shunt requirement for cases undergoing prenatal repair. This option is however available in limited centers across the world and is feasible for few select cases [10] [23].…”

“…Prognosis is likely to be poor, and recurrence risk up to 25% in some cases. Schizencephaly has a variable prognosis and low recurrence risks [23].…”

A rare case of hemimegalencephaly diagnosed prenatally

“…The prognosis is poor, and the only possible treatment is a hemispherectomy to control seizures [3]. Evaluation of HME may be made by ultrasound or magnetic resonance imaging (MRI) [1][2][3][4][5]. However, cortical developmental abnormalities are rarely diagnosed prenatally.…”