Placento-cerebral adhesion: a morphology-based classification derived from a case report and literature review

Placento-cerebral adhesion is an exceptionally rare congenital cranial anomaly with heterogeneous anatomy and inconsistent terminology. We report a neonate with vascularized placento-cerebral adhesion, review the published morphology, and propose a descriptive anatomical framework.

Published human cases were reviewed for the configuration of the placental attachment, tissue continuity, vascular communication, associated anomalies, operative findings, and pathological features. Recurring observable patterns informed the proposed classification.

Three recognizable patterns were identified: Type I, a thin avascular fibrous ABS-like adhesion; Type II, direct placento-neural continuity without demonstrable vascular communication; and Type III, direct continuity with organized vessels. The present Type III lesion required neonatal microsurgical separation, vascular control, preservation of viable pia and venous drainage, and staged soft tissue reconstruction.

The framework standardizes anatomical description and multidisciplinary communication. It is an expert-informed descriptive model, not a validated grading scale, and it should not be used to predict survival, cranial re-ossification, or long-term neurocognitive outcome. Additional cases and prolonged follow-up are required for validation.