Summary
The fetal brain can be evaluated very effectively with high-resolution real-time ultrasound equipment. This paper reviews normal fetal brain anatomy with specific emphasis on artifacts of ultrasound scanning of the brain. A review of the developmental abnormalities seen in utero include ventriculomegaly, anencephaly, encephalocele, meningomyelocele, Dandy-Walker syndrome, holoprosencephaly, craniosynostosis, microcephaly, and agenesis of the corpus callosum. The destructive lesions reviewed include hydranencephaly, infection, intracranial hemorrhage, and mass lesion. Identification of these abnormalities can be extremely helpful in providing the patients with management options and providing the obstetrician with information which can help in obstetric and neonatal therapy.
Similar content being viewed by others
References
Mahoney BS, Callen PW, Filly RA, Hoddick WK (1984) The fetal cisterna magna. Radiology 153: 773–776
Johnson ML, Dunne MG, Mack LA, Rashbaum CL (1980) Evaluation of fetal intracranial anatomy by static and realtime ultrasound. JCU 8: 311–318
Hadlock FP, Deter RL, Park SK (1981) Real-time sonography: ventricular and vascular anatomy of the fetal brain in utero. AJR 136: 133–137
Denkhaus H, Winsberg F (1979) Ultrasonic measurement of the fetal ventricular system. Radiology 131: 781–787
Moore KL (1977) The developing human clinically oriented embryology, 2nd edn, Saunders, Philadelphia
Laing FC, Stamler CE, Jeffrey RB (1983) Ultrasonography of the fetal subarachnoid space. J Ultrasound Med 2: 29–32
Schoenecker SA, Pretorius DH, Manco-Johnson ML (1986) Fetal cranium: common artifacts. J Reprod Med 30: 541–544
Fiske CE, Filly RA (1982) Ultrasound of the normal and abnormal fetal neural axis. Radiol Clin North Am 20: 285–296
Reuter KL, D'Orsi CJ, Raptopoulos VD, Barber FE, Moss W (1982) Sonographic pseudoasymmetry of the prenatal cerebral hemispheres. J Ultrasound Med 1: 91–92
Jeanty P, Chervenak FA, Romero R, Michiels M, Hobbins JC (1984) The sylvian fissure: a commonly mislabeled cranial landmark. J Ultrasound Med 3: 15–18
Amin NM (1983) Normal-pressure hydrocephalus. AFP 28(2): 147–150
Hill A, Volpe JJ (1981) Normal pressure hydrocephalus in the newborn. Pediatrics 68(5): 623–629
Bay C, Kerzin L, Hall B (1979) Recurrence risk in hydrocephalus. Birth Defects 15: 95–105
Rumack CM, Johnson ML (1984) Perinatal and infant brain imaging. Year Book Medical Publishers, Chicago, pp 158, 161
McCullough DC, Balzer-Martin LA (1982) Current prognosis in overt neonatal hydrocephalus. J Neurosurg 57: 378–383
Robertson RD, Sarti DA, Brown WJ, Crandall BF (1981) Congenital hydrocephalus in two pregnancies following the birth of a child with neural tube defect: aetiology and management J Med Genet 18: 105–107
Pretorius DH, Drose JA, Manco-Johnson ML (1986) Fetal lateral ventricular ratio determination during the second trimester. J Ultrasound Med 5: 121–124
Pretorius DH, Davis K, Manco-Johnson ML, Manchester D, Meier PR, Clewell WH (1985) Clinical course of fetal hydrocephalus: 40 cases. AJNR 6: 23–27
Chervenak FA, Berkowitz RL, Romero R, Tortora M, Mayden K, Duncan C, Mahoney MJ, Hobbins JC (1983) The diagnosis of fetal hydrocephalus. Am J Obstet Gynecol 147: 703–716
Penrose LS (1957) Genetics of anencephaly. J Ment Defic Res 1: 4–15
Chervenak FA, Farley MA, Walters LR, Hobbins JC, Mahoney MJ (1984) When is termination of pregnancy during the third trimester morally justifiable? NEJM 310(8): 501–504
Cunningham ME, Walls WJ (1976) Ultrasound in the evaluation of anencephaly. Radiology 118: 165–167
Robinson HP, Hood VD, Adam AH, Gibson A, Ferguson-Smith MA (1980) Diagnostic ultrasound: early detection of fetal neural tube defects. Obstet Gynecol 56: 705–710
Zimmerman RD, Breckbill D, Dennis MW, Davis DO (1979) Cranial CT findings in patients with meningomyelocele. AJR 132: 623–629
Nadich TP, Pudlowski PM, Nadich JB (1980) Computed tomographic signs of the Chiari II malformation III: ventricles and cisterns. Radiology 134: 657–663
Babcock DS, Han BK (1981) Cranial sonographic findings in meningomyelocele. AJR 136: 536–569
Newman GC, Buschi AI, Sugg NK, Kelly JE, Miller JQ (1982) Dandy-Walker syndrome diagnosed in utero by ultrasonography. Neurology 32: 180–184
Dandy WE, Blackfan KD (1914) Internal hydrocephalus. An experimental, clinical and pathological study. Am J Dis Child 8: 406–482
Benda CE (1954) The Dandy-Walker syndrome or the socalled atresia of the foramen of Magendie. J Neuropathol Exp Neurol 13: 14–29
Gardner WJ, Smith JL, Padget DH (1972) The relationship of Arnold-Chiari and Dandy-Walker malformations. J Neurosurg 36: 481–486
Sawaya R, McLaurin RL (1981) Dandy-Walker syndrome. J Neurosurg 55: 89–98
Hart MN, Malamud N, Ellis WG (1972) The Dandy-Walker syndrome. A clinico pathological study based on 28 cases. Neurology 22: 771–780
Tal Y, Freigang B, Dunn HG, Durity FA Moyes PD (1980) Dandy-Walker syndrome: analysis of 21 cases. Develop Med Child Neurol 22: 189–201
Filly RA, Chinn DH, Callen PW (1984) Alobar holoprosencephaly: ultrasonographic prenatal diagnosis. Radiology 151: 455–459
Christensen SL, Rumack CM, Mack LA, Manco-Johnson ML, Babcock DS (1985) Prenatal and neonatal ultrasonic diagnosis of holoprosencephaly. Radiology (in press)
Byrd SE, Harwood-Nash DC, Fitz CR, Rogovitz DM (1977) Computed tomography evaluation of holoprosencephaly in infants and children. J Comput Assist Tomogr 4: 456–462
Birth Defects Compendium, 2nd edn Bergsma D (ed) (1979) Alan R Liss, New York
Smith DW (1982) Recognizable patterns of human malformations, 3rd edn, Saunders Philadelphia, p 617
Babcock DS (1984) The normal, absent and abnormal corpus callosum: sonographic findings. Radiology 151: 449–453
Gebarski SS, Gebarski KS, Bowerman RA, Silver TM (1984) Agenesis of the corpus callosum: sonographic features. Radiology 151: 443–448
Atlas SW, Shkolnik A, Naidich TP (1985) Sonographic recognition of agenesis of the corpus callosum. AJNR 6: 369–375
Harwood-Nash DC, Fitz CR (1976) Congenital malformations of the brain. Neuroradiology in infants and children, vol 3 Mosby, St Louis, pp 1019–1025
Byrd SE, Harwood-Nash DC, Fitz CR (1978) Absence of the corpus callosum: computed tomographic evaluation in infants and children. J Can Assoc Radiol 29: 108–112
Davidoff LM, Dyke CG (1934) Agenesis of the corpus callosum: its diagnosis by encephalography. AJR 32: 1–10
Yakovlev PL, Wadsworth RC (1946) Schizencephalies: a study of congenital clefts in the cerebral mantle: I Clefts with fused lips. J Neuropathol Exp Neurol 5: 16–130
Dublin AB, French BN (1980) Diagnostic image evaluation of hydranencephaly and pictorially similar entities, with emphasis on computed tomography. Radiology 137: 81–91
Carasco CR, Stierman ED, Harnsberger HR, Lee TG (1985) An algorithm for prenatal ultrasound diagnosis of congenital CNS abnormalities. J Ultrasound Med 4: 163–168
Graham D, Guidi S, Sanders RC (1982) Sonographic features of in utero periventricular calcification due to cytomegalovirus infection. J Ultrasound Med 1: 171–172
Dykes FD, Ahmann PA, Lazzara A (1982) Cranial ultrasound in the detection of intracranial calcifications. J Pediatr 100: 406–408
Pretorius DH, Singh S, Manco-Johnson ML, Rumack CM (1986) In utero diagnosis of intracranial hemorrhage resulting in fetal hydrocephalus. J Reprod Med 31: 136–138
Kim MS, Klyaderani MK (1982) Sonographic diagnosis of cerebroventricular hemorrhage in utero. Radiology 142: 279–480
Bondurant S, Boehm FH, Fleischer AC, Machin JE (1984) Antepartum diagnosis of fetal intracranial hemorrhage by ultrasound. Obst Gynecol 63 [Suppl 3]: 25S-27S
Donn SM, Barr M, McLeary RD (1984) Massive intracerebral hemorrhage in utero: sonographic appearance and pathologic correlation. Obst Gynecol 63 [Suppl 3]: 28S-30S
Jackson JC, Blumhagen JD (1983) Congenital hydrocephalus due to prenatal intracranial hemorrhage. Pediatrics 72(3) 344–346
McGahan JP, Haesslein JC, Meyers M (1984) Sonographic recognition of in utero intraventricular hemorrhage. AJR 142: 171–173
Takaku A, Kodama N, Ohara H, Hori (1978) Brain tumor in newborn babies. Child's Brain 4: 365–375
Lipman SP, Pretorius DH, Rumack CM, Manco-Johnson ML (1985) Fetal intracranial teratomas: report of three cases and a review. Radiology 157: 491–494
Anderson FM, Landing BH (1966) Cerebral arachnoid cysts in infants. J Pediatr 69: 88–96
Grundy H, Glasmann A, Burlbaw J, Walton S, Dannar C, Doan L (1985) Hemangioma presenting as a cystic mass in the fetal neck. J Ultrasound Med 4: 147–150
Chervenak FA, Isaacson G, Blakemore KJ, Breg WR, Hobbins JC, Berkowitz RL, Tortora M, Mayden K, Mahoney MJ (1983) Fetal cystic hygroma. NEJM 309: 822–825
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pretorius, D.H., Russ, P.D., Rumack, C.M. et al. Diagnosis of brain neuropathology in utero. Neuroradiology 28, 386–397 (1986). https://doi.org/10.1007/BF00344094
Issue Date:
DOI: https://doi.org/10.1007/BF00344094