Schizencephaly: antenatal and postnatal assessment with colour-flow Doppler imaging

Schizencephaly, a disorder of neuronal migration, is rarely discovered in utero. Three cases, detected in utero and followed through the early neonatal period, were assessed with colour-flow Doppler imaging in an attempt to determine whether the clefts were associated with any demonstrable vascular disturbance. The Doppler spectral wave-forms of the fetal and neonatal internal carotid and middle cerebral arteries were normal in two of the cases, whereas the right middle cerebral artery was persistently occluded in the third. Although Doppler imaging was not performed during the first trimester (when the defect occurs), these findings suggest that a vascular lesion, such as occlusion of the middle cerebral artery with or without complete recanalization, may result in the clefts seen in patients with schizencephaly. Two of the fetuses had been exposed to cocaine in the first trimester, and an association between cocaine-induced vasospasm and schizencephaly is suggested.