Presentation
8 months of amenorrhea
Patient Data
Age: 30 years
Gender: Female
From the case:
Severe hydrocephalus (antenatal)
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Ultrasound of the abdomen demonstrates a foetus. Intracranially there is mostly fluid, with only a thin rim of cerebral tissue. The falx cerebri is present.
Case Discussion
The differential for such an appearance is:
-
hydranencephaly
- thalami are often visible and are not fused
- not associated with midline facial abnormalities
- no cortex present or sometimes small islands of tissue
- severe hydrocephalus
- falx usually present, but may be absent due to severe long-standing hydrocephalus
- bilateral choroid plexus
- thalami not fused
- not associated with midline facial abnormalities
-
alobar holoprosencephaly + / - very large dorsal cyst of holoprosencephaly
- usually coexisting midline facial abnormalities
- no falx
- residual cortical tissue often has a cup or pancake morphology, fused across the mid-line anteriorly
In this case there appears to be a thin rim of cerebral tissue compressed up against the inside of the skull, favoring hydrocephalus.