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Connatal periventricular pseudocysts in the neonate
J H Lu1, D Emons, S Kowalewski
1Department of Neonatology, University Children's Hospital, Bonn, FRG.
Insights
Connatal periventricular pseudocysts, detected via cranial ultrasound, indicate intrauterine issues in newborns. These lesions, linked to infections or genetic conditions, are crucial for assessing infant neurological development.
Area of Science:
- Neonatal neurology
- Pediatric pathology
- Developmental neurobiology
Background:
- Connatal periventricular pseudocysts are significant outcomes of brain insults in developing infants.
- Early diagnosis is critical for clinical management and understanding intrauterine pathologies.
- These lesions can arise from various causes, including infections and genetic abnormalities.
Purpose of the Study:
- To analyze the diverse pathological entities associated with congenital periventricular pseudocysts in infants.
- To highlight the diagnostic utility of real-time cranial ultrasound in detecting these lesions.
- To underscore the clinical significance of these pseudocysts for neurological development.
Main Methods:
- Retrospective case study of 12 infants diagnosed with congenital periventricular pseudocysts.
- Review of clinical data, imaging findings (cranial ultrasound), and etiological factors.
- Classification of pseudocysts into focal paraventricular, subependymal, viral infection, and chromosomal abnormality categories.
Main Results:
- Identified 12 cases of congenital periventricular pseudocysts.
- Categorized cases into focal paraventricular pseudocysts (5), subependymal pseudocyst (3), congenital viral infection (3), and chromosomal abnormality (1).
- Confirmed the role of real-time cranial ultrasound in detecting these lesions in neonates.
Conclusions:
- Congenital periventricular pseudocysts suggest intrauterine pathology and are linked to diverse causes like obstetric complications, viral infections, and chromosomal abnormalities.
- These pseudocystic lesions are detectable in utero or neonatally via cranial ultrasound.
- While not terminal, these findings are clinically important for predicting and managing future neurological development in affected infants.
Abstract:
Connatal periventricular pseudocysts are important sequelae of different noxious insults in the developing brain. Accurate diagnosis of those pathologic entities during early life has therefore become of direct concern to the clinician. Our experience with 12 infants of connatal periventricular pseudocysts provides the basis of this study. They belonged to different pathological entities: focal paraventricular pseudocysts (5 cases), subependymal pseudocyst (3 cases), connatal viral infection (3 cases), and chromosomal abnormality (1 case). When present at birth, they suggest an intrauterine pathology. It has only been with the advent of real-time cranial ultrasound that periventricular pseudocystic lesions can be detected in neonates following an abnormal pregnancy. Some obstetric complications during the second trimester can cause paraventricular or subependymal pseudocyst in the foetus. Neurotrophic viral infection and chromosomal abnormalities have also been implicated in the production of cystic lesions in this region. These lesions are not a terminal event in infants but may be a condition of major clinical importance for further neurological development.