Fetal Head,Spine,Face, and Neck anomalies

What are the different kinds of head shapes?

Doli-chocephaly

• Bra-chycephaly

• Cranio-synostosis

• Micro-cephal

What is the Calvarium?

Bone around the entire skull

What can the Calvarium be associated with?

With skeletal dysplasia due to the minerilization around it

What are the 5 sutures?

sagittal

lamboid

squamous

Posterior fontanele

Coronal

What is a Dolichocephal head?

flattened head

What is a Brachycephaly head?

Rounded and overestimated

What are the 8 bones of the skull

Ethmoid

Sphenoid

Fontal

2 Occipital

2 Parietal

2 Temporal

Lable this image

1-lamboidal

2-parietal

3-Coronal

4-Frontal bone

5-Great sphenoid bone

6-Temporal

7-Squamous suture

What is Cranio-Synostosis?

congenital anomaly caused by the closure of 1 or more than 5 sutures.

Most prominant in M:F (2,1)

What image is this?

Craniosynostosis

What does patients with Craniosynostosis need?

Require a surgical release and cranial valt remodeling

What is Microcephaly?

determined by small BPD

fetal head is much smaller than expected

IS Microcephaly a common condition?

No it is not

What is Microcephaly caused by?

Infections: Rubella,Toxoplasmosis,zika,cytomegalovirus

Exposure of harmful substance(Alcohol,drugs,toxic chemicals)

Interuptions of blood supply

What does this image represent?

Microcephaly

What are the neural tube defects?

NEURAL TUBE DEFECTS

Anencephaly

Acrania/Exencephaly

Encephalocele

Vein of Galen Aneurysm

Arnold Chiari Malformation

Spina Bifida

Agenesis of the Corpus Callosum

Dandy-Walker

Holoprosencephaly

Ventricular System Related

Ventriculomegaly

Hydrocephaly

Hydrancephaly

Aqueductal Stenosis

Choroid plexus cyst

Porencephaly

What is Anencephaly?

Absence of cranium and prosencephalon due to failure of nerural tube.

Who are most likely to be affected by Anencephaly?

Females(4:1)

Cause unknown

What is Anecnephaly associated with?

Spina bifida

Cleft lip

Clubfoot

Omphalocele

polycephaly

What so we see on U/S in patient with Aneccephaly?

Little to no brain tissue

Have polyhydraminos

Orbit very shallow and causes protrusion of the eyes

what does this image show?

Anencephaly

What is Acrania/Excephaly?

parts of the Fetal skull not formed

-Brain tissue is exposed to amniotic fluid and risk of friction on wall and degration

What is Encephalocele?

Parts of the intracranial content through the bony part of skull, Caused by failure of the neural tube to form.

Who is Encephalocele most common in?

Common in Women

May be genetic or due to environmental problem

Associated with Meckle-Gruber syndrome

What does this image represent?

Encephalocele

What are Encephalocele associated with?

Meckel-Gurber syndrome

Encephalocele

PCKD(polycistic kidney disease)

Polydactyly-extra digits

What are Veins of Galen Malformation?

The areteries of thebrain are conected directly to the veins instead of the capillaries causing high blood pressure

What occurs when the Veins of Galen are malformed?

The blood rushes into the vein- and causes too much force and little resistance and the veind dialate

What can a large Malformation result in?

Great amount of blood circulation causing Cardiomegaly,pulmonary hypertension, hydrops

What does the vein of Galen appear as?

Anechoic cystic space, located midline and posterior superior to the 3rd ventricle

What does this image indicate?

Vein of Galen Malformation

Lable this image?

1- superior sagittal sinus

2-Coronal view

3-Inferior sagittal sinus

4-Internal Cerebral vein

5-Vein of Galen

6-Superior we,Ian vein

7-Precentral vein

8Straight sinus

9-tercular Heroph

What are Arnold Chiari Malformation?

Structural defects in the Cerebellum

What are the types of Arnold Chiari malformations?

Type 1* – displacement of the cerebellum posteriorally obliterating

the cisterna magna

Type 2- accompanies a meningomyelocele

Type 3- occurs with an encephalocele

Type 4- no cerebellum develops at a

What is the most common Arnold Chiari Malformation?

Chiari 1 is the most common type thant occurs in the region wher the brain and spinal cord join

What does Arnold Chiari Malformation cause?

The cerebellum and brainstem to lie lower than usual

-a portion of the cerebellar tonsil and protudes out the base of skull into spinal canal.

What is Syringomyelia?

Chronic disorder that involves the spinal cord

What causes Syringomyelia to occur?

Cerobrospinal fluid forund outside the Spina cord and enters the inferior spinal cord known as syrinx

In what patient are Arnold Chiari Malformation seen?

In children with myelomeningocele

What can Arnold Chiari Malformation led to abnormal developent of?

Cerebellar vermis

Medulla oblongata descend into for men magnum

What is frequently present in patient with Arnold Chiari Malformation?

Hydrocephalus

What does this image represent?

Arnold Chiari Malformation

What does this image represent?

Spina Bifida

What does this image represent?

Obliterated Cisterna Magna/Banana sign

When there is Spina Bifida what does we see?

Head sign

hydrocephalus

Obliterated ,Cisterna magna, banana sign,lemon sign

What kind of vertebrae shape do we seen with spine bifida?

U shaped

What is Spina Bifida divided into ?

Occulta(15% covers skin

Aperta (85% exposure of neural canal

What does this image represent?

Spina Bifida

What is a indication of Spina bifida?

High MSAFP

Found in lumbosacral spine

In posterior fossa of head

What does this image represent?

Spina Bifida Meningomyelocele

What are the U/S finding of Spina Bifida?

Banana sign-Cerebellum flattens

Lemon Sign- Frontal bone cave in

Ventriculomegaly

What is this image indicating?

Banana sign

What does this image indicate?

lemon sign

What does this image represent?

Ventriculomegaly

What is the corpus collosum?

Thick band of fibers that connect the RT and LT hemispheres

How does the corpus collosum develop?

Ant- Post

1. the rostrum develops first

2. followed by the genu

3. then the body

4. and lastly the splenium

What does this image indicate?

corpus callosum

What does agenesis of the corpus callosum represent?

IT represents the left and agenesis of corpus collosum.

When corpus is absent the ventricals are set apart and Cavum Septum not normally seen

What is the corpus callosum closely related to?

CC closely related to the Cavum Septum pellicidum which is absent and 3rd Ventrical is higher in the head.

When is the Corpus Callosum formed and best seen?

Formed by the 17th week and best seen after the 22nd week

What is this image representing?

cavum septum pellucidi

What does the agenesis of the corpus callosum represent?

Colpocephaly

What does colpocephaly refer to ?

When the ant and lat horns become narrower and posterior/occipital horn become wider and enlarged

What are the key features of Dandy Walker Syndrome?

Enlargement of the 4th ventrical which allows fluid to flow freely between the upper and lower areas of the brain and spinal cord

What does this image represent?

Dandy Walker syndrome

What are the key features of Dandy Walker Syndrome?

Enlargement of the 4th ventrical

Partial or complete absence of area between the 2 cereabellar hemisphere

Cyst formation near the lower part of skull

What does this image represent?

Dandy Walker syndrome

With dandy walker Syndrome how big is the Cisterna Magna?

Cisterna magna > 1 cm

• 50-70 % have associated

malformations such as absent

corpus callosum and

malformations of the heart, face,

limbs, fingers and toes.

What does this image represent?

Cerebellum posterior fossa

What does this image indicate?

Normal Cerebellum and posterior fossa

What is Holoprosencephaly?

disorder that caused by failure of prosencephalonn to divide into double lobe of cerebral hemisphere

What does this image represent?

Holoprosencephaly

What are the 3 classification of Holoprosencephaly?

Alobar

Semilobar

Lobar

What is Alobar?

Brain not divided and associated with facial deformities

What is semilobaar?

The brain hemisphere is divided and causes an intermediate form of the disorder

What is Lobar holoprosencephaly?

evidence the brain hemisphere is seperated, in some cases the baby can be normal

What do we see in Alobar and Semilobar Holoprosencephaly baby?

Single ventricle

• Fused thalami

• Absent CSP

• Agenesis corpus callosum

What are the associated anomalies of Holoprosencephaly?

Median cleft lip

proboscis on forehead

Cyclopia

What does this image show?

Proboscis

Do most babies die with Holoprosencephaly?

Yes most cases they do die with severe birth defects

What are some environmental causes of Holoprosencephaly?

maternal diabetes mellitus,

maternal alcoholism,

inutero infections with CMV,

rubella or toxoplasmosis, some drug

What are some associated anomalies of Holophosencephaly?

Sever skull and facial defect

What is the common term for the ventricular system?

ventriculomegaly(mildly enlarged)

What term is used when the Ventricular system measures more than >15mm?

Hydrocephalus

What does this image represent?

Dialated lateral ventricle

What does this image show?

Hydrocephalus

What does this image represent?

Dialation of the 3rd and 4th ventricle

Who is Ventriculomegaly most common in?

More in men

What are the sizes?

11-15=mild ventriculomegaly

>15mm= hydrocephaly

Normal width=<1cm

What is this image?

Dangling choroid

Who is Ventriculomegaly most common in ?

Females more than males

What does this image represent?

Ventriculomegaly

What does this image represent?

Dialated 3rd ventricle

What does this image indicate?

Clot within Hydrocephalus

What is Hydranencephaly?

rare condition.

brains cerebral hemispheres are absent and replaced with sac filled cerebrospinal fluid

What is Hydranencephaly thought to be?

Severe hydrocephalus and alobar holoprosencephaly

What is Hydranencephaly caused by?

caused by ischemic lesion due to occlusion of both corotid arteries

What are the causes of Hydranencephaly?

Bilateral occlusion of carotid arteries

Toxoplasmosis

Cytomegalovirus

Cocaine use

What is Aqueductal stenosis a form of?

Form of no communicating hydrocephalus and complete/ partial obstruction of the CSF flow at aqueductsylvian

What does this image indicate?

Aqueductal stenosis