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Fetal neurology

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https://www.readbyqxmd.com/read/28542743/neuroimaging-cardiovascular-physiology-and-functional-outcomes-in-infants-with-congenital-heart-disease
#1
REVIEW
Nathalie H P Claessens, Christopher J Kelly, Serena J Counsell, Manon J N L Benders
This review integrates data on brain dysmaturation and acquired brain injury using fetal and neonatal magnetic resonance imaging (MRI), including the contribution of cardiovascular physiology to differences in brain development, and the relationship between brain abnormalities and subsequent neurological impairments in infants with congenital heart disease (CHD). The antenatal and neonatal period are critical for optimal brain development; the developing brain is particularly vulnerable to haemodynamic disturbances during this time...
May 19, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28541503/reduced-efficacy-of-the-pipeline-embolization-device-in-the-treatment-of-posterior-communicating-region-aneurysms-with-fetal-posterior-cerebral-artery-configuration
#2
Anil K Roy, Brian M Howard, Diogo C Haussen, Joshua W Osbun, Sameer H Halani, Susana L Skukalek, Frank Tong, Raul G Nogueira, Jacques E Dion, Charles M Cawley, Jonathan A Grossberg
BACKGROUND: Aneurysms at the origin of the posterior communicating artery (PcommA) have been demonstrated to be effectively treated with the pipeline embolization device (PED). Much less is known about the efficacy of the PED for aneurysms associated with a fetal posterior cerebral artery (fPCA) variant. OBJECTIVE: To study PED treatment efficacy of PcommA aneurysms, including fPCA aneurysms. METHODS: A prospectively maintained university database of aneurysm patients treated with the PED was retrospectively reviewed...
May 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28536839/maternal-fetal-surgery-for-myelomeningocele-some-thoughts-on-ethical-legal-and-psychological-issues-in-a-western-european-situation
#3
Frank Van Calenbergh, Luc Joyeux, Jan Deprest
BACKGROUND: The results of the Management of Myelomeningocele Study (MOMS) randomized controlled trial have demonstrated that maternal-fetal surgery (MFS) for myelomeningocele (MMC) compared to postnatal MMC repair has clear neurological benefits for the child at 12 and 30 months of age. Level I evidence nevertheless does not provide answers to many questions in this delicate field. Since the beginning of 2012, our fetal center has been offering MFS for spina bifida aperta (SBA) to patients from different European and non-European countries, in a societal context where termination of pregnancy is the option chosen by most patients when being informed of this diagnosis...
May 23, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28532678/selective-intrauterine-growth-restriction-in-monochorionic-diamniotic-twin-pregnancies
#4
REVIEW
Mar Bennasar, Elisenda Eixarch, Josep Maria Martinez, Eduard Gratacós
Selective intrauterine growth restriction (sIUGR) affects 10-15% of all monochorionic pregnancies. Early severe forms are associated with intrauterine demise or neurological adverse outcome for both twins. The characteristics of umbilical artery (UA) Doppler in the IUGR fetus determine three clinical types: (I) normal UA Doppler and associated with good prognosis; (II) persistently absent/reverse UA end-diastolic flow and associated with early deterioration of the IUGR twin and very preterm delivery; (III) intermittently absent/reverse end-diastolic flow in the UA, and associated with unexpected fetal demise or neurological injury in one or both twins...
May 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28528582/searching-the-web-a-survey-on-the-quality-of-advice-on-postnatal-sequelae-of-intrauterine-growth-restriction-and-the-implication-of-developmental-origins-of-health-and-disease
#5
S Perzel, H Huebner, W Rascher, C Menendez-Castro, A Hartner, F B Fahlbusch
Intrauterine growth restriction (IUGR) and fetal growth restriction (FGR) are pregnancy complications associated with morbidity in later life. Despite a growing body of evidence from current research on developmental origins of health and disease (DOHaD), little information is currently provided to parents on long-term metabolic, cardiovascular and neurologic consequences. As parents strongly rely on internet-based health-related information, we examined the quality of information on IUGR/FGR sequelae and DOHaD in webpages used by laypersons...
May 22, 2017: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/28527483/single-fetal-death-in-monochorionic-twin-pregnancy-co-twin-prognosis-and-neonatal-outcome
#6
Emídio Vale-Fernandes, Joana Dias, Belandina Gil, Alexandra Cadilhe
The incidence of single fetal death in twin pregnancy varies from 0.5% - 6.8%, leaving the surviving fetus with increased morbi-mortality. The prognosis is worse in monochorionic pregnancies. In addressing these cases it should be noted referral to tertiary center with differentiated perinatal support, induction of fetal lung maturation and termination of pregnancy if there's loss of fetal well-being or possibility of maternal complications and suspected neurological sequelae in the surviving fetus. The risk of iatrogenic prematurity should always be weighed with the possible consequences arising from the fetus staying in a hostile uterine environment...
February 27, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28516217/prenatal-surgery-for-myelomeningocele-review-of-the-literature-and-future-directions
#7
Gregory G Heuer, Julie S Moldenhauer, N Scott Adzick
Open spina bifida or myelomeningocele (MMC) is one of the most common serious congenital malformations. Historically, this condition has been treated with closure of the MMC defect shortly after birth. The goal of postnatal closure is to cover the exposed spinal cord and prevent infection. However, postnatal surgery does not reverse or prevent the neurologic injury seen in MMC, reverse hindbrain herniation, or prevent hydrocephalus. The neurologic defects result from primary incomplete neurulation and secondary chronic prenatal damage to the exposed neural elements through mechanical and chemical trauma...
May 17, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28509324/three-dimensional-neurosonography-a-novel-field-in-fetal-medicine
#8
Michał Lipa, Ritsuko Kimata Pooh, Mirosław Wielgoś
Neurosonography is a promising technique for prenatal diagnosis, combining features of ultrasound imaging with fetal neurology. The brain is a three-dimensional structure, therefore observing brain structure in the three basic planes (sagittal, coronal and axial) is mandatory. The anterior fontanelle and sagittal suture may serve as acoustic ultrasound windows in the transvaginal brain scan, allowing to obtain high-resolution neuroimages of the intracranial structures. Furthermore, three-dimensional (3D) ultrasound combined with the transvaginal brain approach provides detailed and sophisticated neuroimages...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28503326/incomplete-paraplegia-caused-by-extramedullary-hematopoiesis-in-a-patient-with-thalassemia-intermedia
#9
Nurhasyimah Hisamud-Din, Nadia Mohd Mustafah, Aishah Ahmad Fauzi, Natiara Mohamad Hashim
INTRODUCTION: Extramedullary hematopoiesis (EMH) is the production of blood cell precursors outside the bone marrow that occur in various hematological diseases. In patients with thalassemia intermedia, ineffective erythropoiesis drives compensatory EMH in the liver, pancreas, pleura, spleen, ribs and spine. CASE PRESENTATION: We describe a patient with thalassemia intermedia who presented with acute neurological symptoms caused by paraspinal EMH, which responded well to combination therapy of steroid, hypertransfusion, laminectomy and excision of pseudotumor and hydroxyurea therapy to boost the formation of fetal haemoglobin...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28497181/new-directions-in-fetal-surgery-for-myelomeningocele
#10
Sandra K Kabagambe, Y Julia Chen, Melissa A Vanover, Payam Saadai, Diana L Farmer
The treatment of children with myelomeningocele (MMC) has improved over time, from supportive management to early postnatal closure to prenatal repair of the defect. The Management of Myelomeningocele Study (MOMS) showed that prenatal repair of MMC resulted in improved neurological outcomes compared to postnatal closure. Follow-up studies showed that prenatal repair was, as with any other fetal intervention, associated with higher rates of obstetrical complications. There was no significant difference in urological outcomes...
May 11, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28493900/genomic-biomarkers-of-prenatal-intrauterine-inflammation-in-umbilical-cord-tissue-predict-later-life-neurological-outcomes
#11
Sloane K Tilley, Robert M Joseph, Karl C K Kuban, Olaf U Dammann, T Michael O'Shea, Rebecca C Fry
BACKGROUND: Preterm birth is a major risk factor for neurodevelopmental delays and disorders. This study aimed to identify genomic biomarkers of intrauterine inflammation in umbilical cord tissue in preterm neonates that predict cognitive impairment at 10 years of age. STUDY DESIGN: Genome-wide messenger RNA (mRNA) levels from umbilical cord tissue were obtained from 43 neonates born before 28 weeks of gestation. Genes that were differentially expressed across four indicators of intrauterine inflammation were identified and their functions examined...
2017: PloS One
https://www.readbyqxmd.com/read/28493821/multicentric-studies-of-the-fetal-neurobehavior-by-kanet-test
#12
Asim Kurjak, Panos Antsaklis, Milan Stanojevic, Radu Vladareanu, Simona Vladareanu, Raul Moreira Neto, Lara Spalldi Barisic, Selma Porovic, Taib Delic
Assessment of fetal neurobehavior and detection of neurological impairment prenatally has been a great challenge in perinatal medicine. The evolution of four-dimensional (4D) ultrasound not only enabled a better visualization of fetal anatomy but also allowed the study of fetal behavior in real time. Kurjak Antenatal Neurodevelopmental Test (KANET) was developed for the assessment of fetal neurobehavior and the detection of neurological disorders, based on the assessment of the fetus by application of 4D ultrasound in the same way that a neonate is assessed postnatally...
May 11, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28475388/natural-history-of-fetal-isolated-ventriculomegaly-comparison-between-pre-and-post-natal-imaging
#13
Sharon Perlman, Omer Bar-Yosef, Jeffrey-Michael Jacobson, Yinon Gilboa, Estela Derazne, Reuven Achiron, Eldad Katorza
Purpose - The aim of our study was to assess the agreement between pre- and post-natal measurements in prenatal isolated ventriculomegaly. Methods - Ninety-two women were referred for lateral ventricular abnormality and followed prospectively. Cases with at least one dilated lateral ventricle ≥ 10 mm and a normal work up (serological tests, detailed anatomical scan, fetal brain MR imaging, genetic counseling and amniocentesis) were considered idiopathic ventriculomegaly and comprised the study group for post-natal follow up...
May 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28467756/maternal-inflammation-fetal-brain-implications-and-suggested-neuroprotection-a-summary-of-10-years-of-research-in-animal-models
#14
REVIEW
Yuval Ginsberg, Nizar Khatib, Zeev Weiner, Ron Beloosesky
A growing body of evidence implies that maternal inflammation during pregnancy is associated with increased risk of neurodevelopmental disorders in the offspring. The pathophysiological mechanisms by which maternal inflammation evokes fetal brain injury and contributes to long-term adverse neurological outcomes are not completely understood. In this review, we summarize 10 years of our research experience on maternal inflammation and the implications upon the fetal/offspring brain. We review our findings regarding the underlying mechanisms that connects maternal inflammation and fetal brain injuries (e...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28463844/early-delivery-of-sacrococcygeal-teratoma-with-intraspinal-extension
#15
Erin E Perrone, Marcus D Jarboe, Cormac O Maher, Deborah R Berman, Maria Ladino-Torres, Jeannie Kreutzman, Marjorie C Treadwell, George B Mychaliska
Sacrococcygeal teratoma (SCT) with intraspinal extension is rare. There is a risk of paraplegia associated with prolonged spinal cord compression. We present the case of an infant with a prenatal diagnosis of an SCT with a large intraspinal component that was causing compression of the lower spinal cord. Ultrasound at 33 weeks showed bilateral lower extremity and foot movement without hydrops or cardiac failure. Multidisciplinary decision was made to administer betamethasone and proceed with Cesarean delivery at 34 weeks...
May 3, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28458583/current-perspectives-on-fetal-and-neonatal-alloimmune-thrombocytopenia-increasing-clinical-concerns-and-new-treatment-opportunities
#16
REVIEW
Heidi Tiller, Anne Husebekk, Maria Therese Ahlen, Tor B Stuge, Bjørn Skogen
Differences in platelet type between the fetus and the mother can lead to maternal immunization and destruction of the fetal platelets, a condition named fetal and neonatal alloimmune thrombocytopenia (FNAIT). FNAIT is reported to occur in ~1 per 1,000 live born neonates. The major risk is intracranial hemorrhage in the fetus or newborn, which is associated with severe neurological complications or death. Since no countries have yet implemented a screening program to detect pregnancies at risk, the diagnosis is typically established after the birth of a child with symptoms...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28445905/prenatal-diagnosis-of-galen-vein-aneurysm-using-ultrasonography-and-magnetic-resonance-imaging-and-perinatal-and-long-term-neurological-outcomes-a-case-series
#17
Pedro Pires, Larisse de Brito Aurélio Martins, Norma Maria Tenório Brito Pires, Heron Werner, Adilson Cunha Ferreira, Edward Araujo Júnior
Objective To describe the prenatal diagnosis of Galen vein aneurysm (GVA) based on ultrasonography and magnetic resonance imaging (MRI) in a series of cases, as well as its postnatal outcomes and follow-up until 4 years of age. Methods A retrospective longitudinal study was performed, analyzing a database comprising seven cases of prenatal diagnosis of GVA at two Brazilian institutions from February of 2000 to May of 2012. The following data were evaluated: gestational age at diagnosis, GVA dimensions on ultrasonography, associated fetal changes, findings on fetal echocardiography, gestational age at delivery, type of delivery, birth weight, Apgar score at the 1st and 5th minutes, neonatal outcomes, and survival with follow-up until 4 years of age...
April 26, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28442989/perinatal-brain-injury-as-a-consequence-of-preterm-birth-and-intrauterine-inflammation-designing-targeted-stem-cell-therapies
#18
REVIEW
Madison C B Paton, Courtney A McDonald, Beth J Allison, Michael C Fahey, Graham Jenkin, Suzanne L Miller
Chorioamnionitis is a major cause of preterm birth and brain injury. Bacterial invasion of the chorion and amnion, and/or the placenta, can lead to a fetal inflammatory response, which in turn has significant adverse consequences for the developing fetal brain. Accordingly, there is a strong causal link between chorioamnionitis, preterm brain injury and the pathogenesis of severe postnatal neurological deficits and cerebral palsy. Currently there are no treatments to protect or repair against brain injury in preterm infants born after pregnancy compromised by intrauterine infection...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28439323/caudal-regression-syndrome-a-case-series-of-a-rare-congenital-anomaly
#19
Yogesh Kumar, Nishant Gupta, Kusum Hooda, Pranav Sharma, Salil Sharma, Puneet Kochar, Daichi Hayashi
BACKGROUND: Caudal regression syndrome is a rare, neural tube defect characterized by an abnormal development of the caudal aspect of the vertebral column and the spinal cord., It results in neurological deficits ranging from bladder and bowel involvement to severe sensory and motor deficits in the lower limbs. Maternal diabetes, genetic factors and some teratogens have been shown to be associated with its pathogenesis. Caudal regression syndrome is usually diagnosed initially by antenatal ultrasound with more definitive diagnosis made by antenatal or postnatal MRI...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28435652/stroke-in-a-child-with-hemoglobin-sc-disease-a-case-report-describing-use-of-hydroxyurea-after-transfusion-therapy
#20
Diana Fridlyand, Caroline Wilder, E Leila Jerome Clay, Bruce Gilbert, Betty S Pace
Children with hemoglobin SC (HbSC) disease suffer a significant incidence of silent cerebral infarcts but stroke is rare. A 2-year-old African American boy with HbSC disease presented with focal neurologic deficits associated with magnetic resonance imaging evidence of cerebral infarction with vascular abnormalities. After the acute episode he was treated with monthly transfusions and subsequently transitioned to hydroxyurea therapy. The benefits of hydroxyurea as a fetal hemoglobin inducer in HbSC disease, to ameliorate clinical symptoms are supported by retrospective studies...
March 22, 2017: Pediatric Reports
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