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Related Experiment Videos

The Arnold-Chiari type II malformation at midgestation.

E Beuls1, L Vanormelingen, J Van Aalst

  • 1Department of Anatomy, University of Limburg, Diepenbeek, Belgium. ebeu@snch.azm.nl

Pediatric Neurosurgery
|July 24, 2003
PubMed
Summary

Arnold-Chiari malformation type II (ACMII) shows developmental failures up to 20 weeks, with cerebellar overgrowth dominating later. Fetal surgery may allow normal brain growth, but some early anomalies may persist.

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Area of Science:

  • Neuroscience
  • Developmental Biology
  • Medical Imaging

Background:

  • Arnold-Chiari malformation type II (ACMII) is a congenital condition affecting brain development.
  • Previous research suggests ACMII may be reversible following fetal surgical intervention for myelomeningocele.

Purpose of the Study:

  • To investigate the developmental characteristics of ACMII at 20 weeks gestation.
  • To compare the fetal ACMII hindbrain with that of a neurologically intact fetus.

Main Methods:

  • In vitro high-field magnetic resonance microscopy (9.4 T) was utilized.
  • Comparative analysis was performed on a 20-week human fetal ACMII specimen and a control.

Main Results:

  • Up to 20 weeks, developmental failures from early herniation are prominent in ACMII.

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  • Post-20 weeks, accelerated and disproportionate cerebellar growth becomes the dominant feature.
  • Early embryonic hindbrain herniation causes some irreversible anomalies.

    • Conclusions:

    • Midgestational fetal surgery for myelomeningocele can halt cerebrospinal fluid leakage, potentially enabling normal posterior fossa development.
    • While surgery may facilitate cerebellar and brainstem growth, some early developmental anomalies may not be reversible.