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previously visited 061031 GERMINAL MATRIX HEMORRHAGE AND MYELOMENINGOCELE Random Case
Authored By: pedrad CSH, Radiologist, Chung Shan Medical University Hospital, Taiwan.
Patient: 1 day old
History:

Prematurity with gestational age: 30 wks; Birth body weight: 1330 gm
Poor activity and weakness of lower limbs at birth.
A reddish protruding mass over lower back with small clear discharge.
Pregnancy history: high alphfetoprotein (AFP):109(>20) at 17 wks.

Images:[small]mediumlargeas-submittedimages only

Fig. 1

Fig. 2: T2 sag

Fig. 3: T1 Gd sag

Fig. 4: T1 axi

Fig. 5: T2 axi

Fig. 6: T2 sag

Fig. 7: T2 sag

Fig. 8: T2 sag

Fig. 9: T1 Gd cor

Fig. 10: T1 Gd cor

Fig. 11: 3 month old, pre OP
Images:[small]mediumlargeas-submittedimages only
Findings:

MRI of brain and lower spine with T1, T2, and with IV contrast:

1. Relative smooth cerebral gyri and shallow sulci with the
   appearance about 28-29 weeks, mild delayed brain development
   can be suspected. Transcerebellar diameter (TCD): 32mm.
2. Some short T1 and T2 materials in left subependymal region and
   bilateral occipital horns of lateral ventricles with
   fluid-fluid levels, suggesting intracellular methemoglobin
   from germinal matrix hemorrhage.
3. Mild dilatation of bilateral lateral ventricles (depth of lateral
   ventricle= 1.0cm > 0.8cm) and presence of MR dangling
   choroid plexus in left lateral ventricle, suggesting mild hydrocephalus.
4. A 2.4x0.8 cm long T1 and T2 protruding mass with CSF and
   neural tissue containment without IV contrast enhancement
   over sacral region, in favor of myelomeningocele with tethered
   cord, but without MR evidence of infection.

Diagnosis:

1. Germinal matrix periventricular and intraventricular
   hemorrhage with mild hydrocephalus.
2. Myelomeningocele with tethered cord, sacral region.

Comments: post a comment

Q: Why this newborn received MR scan of brain?

A: Whenever a neural tube abnormality is detected, the fetal head

     should be carefully evaluated for evidence of any brain

     malformation, such as Arnold-Chiari type II malformation.

By Dr. Tsao

--pedrad CSH, 2006-11-07 01:18:25
Additional Details:

Case Number: 7099268Last Updated: 02-19-2007
Rating:

0 ratings
Anatomy: Spine and Peripheral Nervous System   Pathology: Congenital
Modality: Photograph, MRAccess Level: Readable by all users
Keywords: germinal matrix hemorrhage myelomeningocele danglingACR: 368.1452Contained in: Myelomeningocele/meningocele
Case has been viewed 1382 times.

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