Foetal disruptive brain injuries: Diagnosing the underlying pathogenetic mechanisms with cranial ultrasonography
Developmental Medicine & Child Neurology, vol. 67, pp. 1383–1408
Abstract
Antenatal destructive events affecting the central nervous system of the foetus lead to disruptive brain lesions that are often associated with impaired neurodevelopment. The pathogenesis of these lesions encompasses a range of causes, including haemorrhagic, embolic, or other vascular events; exposure to teratogens, such as drugs or substance abuse; congenital brain infections; genetic conditions; and metabolic disorders. Cranial ultrasonography is the first-line imaging modality to diagnose these antepartum brain lesions in the newborn infant; it is often complemented by brain magnetic resonance imaging to detect associated neuronal dysmigration and dysplasia. Using a pictorial approach, a differential diagnosis of foetal disruptive brain lesions and common findings related to antenatal brain damage can be made, including antenatal haemorrhagic and ischaemic brain injuries, porencephaly, schizencephaly, multicystic encephalomalacia, and hydranencephaly, as well as germinolytic cysts and lenticulostriate vasculopathy. The main conditions associated with foetal brain disruption, such as genetic cerebral vascular diseases, monochorionic twin pregnancies, congenital heart disease, maternal drug use, congenital infections, and inborn errors of metabolism can be used to illustrate typical imaging patterns that, when combined with clinical presentation, can assist in identifying the underlying mechanisms and causes, thus supporting individualized patient management.
Authors 8
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Hospital Sant Joan de Déu Barcelona · Hospital Clínic de Barcelona · Institut de Recerca Sant Joan de Déu · Universitat de Barcelona
Affiliation as printed
Department of Neonatology Hospital Clínic Barcelona, BCNatal (Barcelona Centre for Maternal, Fetal and Neonatal Medicine) Barcelona Spain
Department of Neonatology Hospital Sant Joan de Déu, BCNatal (Barcelona Centre for Maternal, Fetal and Neonatal Medicine) Barcelona Spain
Department of Surgery and Medical‐Surgical Specialties, Faculty of Medicine and Health Sciences Universitat de Barcelona Barcelona Spain
Institut de Recerca Sant Joan de Déu Barcelona Spain
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Hospital Sant Joan de Déu Barcelona · Institut de Recerca Sant Joan de Déu · Universitat de Barcelona
Affiliation as printed
Department of Neonatology Hospital Sant Joan de Déu, BCNatal (Barcelona Centre for Maternal, Fetal and Neonatal Medicine) Barcelona Spain
Department of Surgery and Medical‐Surgical Specialties, Faculty of Medicine and Health Sciences Universitat de Barcelona Barcelona Spain
Institut de Recerca Sant Joan de Déu Barcelona Spain
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Affiliation as printed
Department of Neonatology University Hospital Zurich Zurich Switzerland
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Hospital Sant Joan de Déu Barcelona · Institut de Recerca Sant Joan de Déu
Affiliation as printed
Department of Genetics Hospital Sant Joan de Déu Barcelona Spain
Institut de Recerca Sant Joan de Déu Barcelona Spain
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Affiliation as printed
Department of Neonatology Hospital Clínic Barcelona, BCNatal (Barcelona Centre for Maternal, Fetal and Neonatal Medicine) Barcelona Spain
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Hospital Costa del Sol · Hospital Universitari Germans Trias i Pujol
Affiliation as printed
Department of Neonatology Hospital Universitario Costa del Sol Marbella Spain
Department of Paediatrics Hospital Germans Trias i Pujol Badalona Spain
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Linda S. de Vries Aachen Department of Pediatrics Division of Neonatology Leiden University Medical Center Leiden The Netherlands
Leiden University Medical Center · University Medical Center Utrecht
Affiliation as printed
Department of Neonatology University Medical Center Utrecht Utrecht the Netherlands
Department of Pediatrics, Division of Neonatology Leiden University Medical Center Leiden the Netherlands
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Affiliation as printed
Department of Neonatology Brussels Belgium
Department of Neonatology ZNA Middelheim Antwerp Belgium
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