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FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY

Year 2019, Volume: 82 Issue: 2, 123 - 126, 19.06.2019
https://doi.org/10.26650/IUITFD.2018.0008

Abstract

Objective: Brain shrinkage in fetal life is a dismal, misunderstood anomaly. In this report, we described a rare case of severe brain shrinkage diagnosed in the 25th weeks of gestation complicated with fetal anemia and ascites. Case Report: We detected polyhydramnios, ascites and severe brain anomaly in the fetus. Although the head circumference was normal; the brain tissue was atrophic and positioned in the center of the skull. The two cerebral hemispheres were adequately developed. Subarachnoid space was much extended, and the surface of the brain was smooth. Also, we detected severe fetal anemia. Perinatal infectious diseases were excluded. Fetal cranial MRI confirmed the brain shrinkage and TOP were performed. Conclusion: We showed a unique fetal brain malformation which comprises intracranial shrinkage and extreme subarachnoid space wideness without microcephaly. It is not well recognized in the literature, and the etiology is unclear.

References

  • 1. Maiser SE, Chen WJ, Miller JA, West JR. Fetal alcohol exposure and temporal vulnerability regional differences in alcohol-induced microencephaly as a function of the timing of binge-like alcohol exposure during rat brain development. Alcohol Clin Exp Res 1997;21:1418-28.
  • 2. Tongsong T, Puntachhai M, Mekjarasnapha M, Traısrısılp K. Severe fetal brain shrinkage following heavy maternal alcohol consumption. Ultrasound Obstet Gynecol 2014;44:245-47.
  • 3. Jones KL, Smith DW. Recognition of the fetal alcohol syndrome in early infancy. Lancet 1973;302:999-1001.
  • 4. Charness ME, Safran RM, Perides G. Ethanol inhibits neural cell-cell adhesion. J Biol Chem 1994;269:9304-9.
  • 5. Mattson SN, Jernigan TL, Riley EP. MRI and prenatal alcohol exposure: images provide insight into FAS. Alcohol Health Res. World 1994;18:49-52.
  • 6. Astley S, Aylward EH, Olson HC, et al. Magnetic resonance imaging outcomes from a comprehensive magnetic resonance study of children with fetal alcohol syndrome spectrum disorders. Alcohol Clin Exp Res 2009;33:1671-89.
  • 7. Roussotte F, Sulik K, Mattson S, et al. Regional brain volume reductions relate to facial dysmorphology and neurocognitive function in fetal alcohol spectrum disorders. Hum. Brain Mapp 2012;33:920-37.
  • 8. Bhide A, Acharya G, Bilardo CM, Brezinka C, Cafici C, Hernandez-Andrade E. ISUOG practice guidelines: use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol 2013;41:233-9.
  • 9. Lindenbach BD, Rice CM. Molecular biology of flaviviruses. Adv Virus Res 2003;59:23-61.
  • 10. Junior E, Carvalho FH, Tonni G, Werner H. Prenatal imaging findings in fetal Zika virus infection Curr Opin Obstet Gynecol 2017;29:95-105.
  • 11. Kagan K, Hamprecht K. Cytomegalovirus infection in pregnancy. Arch Gynecol Obstet 2017;296:15-26.
  • 12. Bianchi DW, Crombleholme TM, D’Alton ME, Malone FD. Hydranencephaly. In: Fetology: Diagnosis and Management of the Fetal Patent. New York NY: McGraw-Hill; 2010:130-3.
  • 13. Russell LJ, Weaver DD, Bull MJ, Weinbaum M. In utero brain destruction resulting in collapse of the fetal skull, microcephaly, scalp rugae, and neurologic impairment: the fetal brain disruption sequence. Am J Med Genet 1984;17(2):509-21.

FETAL BEYİN BÜZÜŞMESİ, NADİR, İLGİ ÇEKİCİ BİR ANOMALİ

Year 2019, Volume: 82 Issue: 2, 123 - 126, 19.06.2019
https://doi.org/10.26650/IUITFD.2018.0008

Abstract

Amaç: Fetal hayatta gerçekleşen beyin büzüşmesi iyi anlaşılamamış, kötü bir anomalidir. Bu vaka sunumunda fetal anemi ve asitle komplike olmuş ve 25. haftada tanı almış ciddi bir beyin büzüşmesi anomalisini tanımladık. Vaka Sunumu: Fetüste polihidramniyos, asit ve ağır bir beyin anomalisi saptadık. Kafa çevresi normal sınırlarda olmasına rağmen; beyin dokusu atrofikti ve kafatasının ortasında yerleşmişti. Her iki hemisfer yeterli ölçüde gelişmişti. Subaraknoid mesafe oldukça genişti ve beyin yüzeyi düzleşmişti. Ayrıca fetüste ağır anemi saptadık. Perinatal enfeksiyonlar dışlandı. Fetal MRI beyin büzüşmesini doğruladı ve aileye gebeliğin terminasyon seçeneği sunuldu. Sonuç: Mikrosefali eşlik etmeksizin beyin büzüşmesi ve aşırı genişlemiş subaraknoid mesafe ile tanımlanan nadir bir beyin malformasyonunu gösterdik. Bu anomali literatürde yeteri kadar tanımlanmamıştır ve etiyolojisi henüz aydınlatılamamıştır.

References

  • 1. Maiser SE, Chen WJ, Miller JA, West JR. Fetal alcohol exposure and temporal vulnerability regional differences in alcohol-induced microencephaly as a function of the timing of binge-like alcohol exposure during rat brain development. Alcohol Clin Exp Res 1997;21:1418-28.
  • 2. Tongsong T, Puntachhai M, Mekjarasnapha M, Traısrısılp K. Severe fetal brain shrinkage following heavy maternal alcohol consumption. Ultrasound Obstet Gynecol 2014;44:245-47.
  • 3. Jones KL, Smith DW. Recognition of the fetal alcohol syndrome in early infancy. Lancet 1973;302:999-1001.
  • 4. Charness ME, Safran RM, Perides G. Ethanol inhibits neural cell-cell adhesion. J Biol Chem 1994;269:9304-9.
  • 5. Mattson SN, Jernigan TL, Riley EP. MRI and prenatal alcohol exposure: images provide insight into FAS. Alcohol Health Res. World 1994;18:49-52.
  • 6. Astley S, Aylward EH, Olson HC, et al. Magnetic resonance imaging outcomes from a comprehensive magnetic resonance study of children with fetal alcohol syndrome spectrum disorders. Alcohol Clin Exp Res 2009;33:1671-89.
  • 7. Roussotte F, Sulik K, Mattson S, et al. Regional brain volume reductions relate to facial dysmorphology and neurocognitive function in fetal alcohol spectrum disorders. Hum. Brain Mapp 2012;33:920-37.
  • 8. Bhide A, Acharya G, Bilardo CM, Brezinka C, Cafici C, Hernandez-Andrade E. ISUOG practice guidelines: use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol 2013;41:233-9.
  • 9. Lindenbach BD, Rice CM. Molecular biology of flaviviruses. Adv Virus Res 2003;59:23-61.
  • 10. Junior E, Carvalho FH, Tonni G, Werner H. Prenatal imaging findings in fetal Zika virus infection Curr Opin Obstet Gynecol 2017;29:95-105.
  • 11. Kagan K, Hamprecht K. Cytomegalovirus infection in pregnancy. Arch Gynecol Obstet 2017;296:15-26.
  • 12. Bianchi DW, Crombleholme TM, D’Alton ME, Malone FD. Hydranencephaly. In: Fetology: Diagnosis and Management of the Fetal Patent. New York NY: McGraw-Hill; 2010:130-3.
  • 13. Russell LJ, Weaver DD, Bull MJ, Weinbaum M. In utero brain destruction resulting in collapse of the fetal skull, microcephaly, scalp rugae, and neurologic impairment: the fetal brain disruption sequence. Am J Med Genet 1984;17(2):509-21.
There are 13 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section RESEARCH
Authors

Gürcan Türkyılmaz 0000-0002-5514-0233

Şahin Avcı This is me 0000-0001-9545-6657

Umut Altunoğlu This is me 0000-0002-3172-5368

Emircan Ertürk This is me 0000-0003-0169-6903

Melis Cantürk This is me 0000-0003-1114-4678

Tuğba Sivrikoz This is me 0000-0001-5482-9429

İbrahim Kalelioğlu This is me 0000-0002-5504-2166

Recep Has This is me 0000-0002-1372-8506

Atıl Yüksel This is me

Publication Date June 19, 2019
Submission Date September 14, 2018
Published in Issue Year 2019 Volume: 82 Issue: 2

Cite

APA Türkyılmaz, G., Avcı, Ş., Altunoğlu, U., Ertürk, E., et al. (2019). FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY. Journal of Istanbul Faculty of Medicine, 82(2), 123-126. https://doi.org/10.26650/IUITFD.2018.0008
AMA Türkyılmaz G, Avcı Ş, Altunoğlu U, Ertürk E, Cantürk M, Sivrikoz T, Kalelioğlu İ, Has R, Yüksel A. FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY. İst Tıp Fak Derg. June 2019;82(2):123-126. doi:10.26650/IUITFD.2018.0008
Chicago Türkyılmaz, Gürcan, Şahin Avcı, Umut Altunoğlu, Emircan Ertürk, Melis Cantürk, Tuğba Sivrikoz, İbrahim Kalelioğlu, Recep Has, and Atıl Yüksel. “FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY”. Journal of Istanbul Faculty of Medicine 82, no. 2 (June 2019): 123-26. https://doi.org/10.26650/IUITFD.2018.0008.
EndNote Türkyılmaz G, Avcı Ş, Altunoğlu U, Ertürk E, Cantürk M, Sivrikoz T, Kalelioğlu İ, Has R, Yüksel A (June 1, 2019) FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY. Journal of Istanbul Faculty of Medicine 82 2 123–126.
IEEE G. Türkyılmaz, Ş. Avcı, U. Altunoğlu, E. Ertürk, M. Cantürk, T. Sivrikoz, İ. Kalelioğlu, R. Has, and A. Yüksel, “FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY”, İst Tıp Fak Derg, vol. 82, no. 2, pp. 123–126, 2019, doi: 10.26650/IUITFD.2018.0008.
ISNAD Türkyılmaz, Gürcan et al. “FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY”. Journal of Istanbul Faculty of Medicine 82/2 (June 2019), 123-126. https://doi.org/10.26650/IUITFD.2018.0008.
JAMA Türkyılmaz G, Avcı Ş, Altunoğlu U, Ertürk E, Cantürk M, Sivrikoz T, Kalelioğlu İ, Has R, Yüksel A. FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY. İst Tıp Fak Derg. 2019;82:123–126.
MLA Türkyılmaz, Gürcan et al. “FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY”. Journal of Istanbul Faculty of Medicine, vol. 82, no. 2, 2019, pp. 123-6, doi:10.26650/IUITFD.2018.0008.
Vancouver Türkyılmaz G, Avcı Ş, Altunoğlu U, Ertürk E, Cantürk M, Sivrikoz T, Kalelioğlu İ, Has R, Yüksel A. FETAL BRAIN SHRINKAGE: A RARE, MYSTIFYING ANOMALY. İst Tıp Fak Derg. 2019;82(2):123-6.

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