Congenital meningoencephalocele

Case contributed by Amr Farouk
Diagnosis almost certain


25 years old female patient pregnant 7 months with the prenatal ultrasound demonstrating an abnormality. MRI was performed for further evaluation.

Patient Data

Age: 25 years old
Gender: Female

Maternal findings: A single intrauterine fetus is identified in the transverse lie, the placenta is fundal anterior with left lateral uterine wall extension not reaching to the internal cervical os. The distance between the lower edge of the placenta & the internal os is 7.3 cm. The cervix is closed. There is no evidence of placenta previa. No retroplacental hematomas.A three-vessel cord was identified.Average amniotic fluid volume.

Fetal findings: Defective posterior cranial vault with a large well defined cystic lesion in left posterior parietal and occipital regions communicating to the left posterior lateral ventricle with eccentric thinning out of the overlying brain parenchyma herniating together outside the confinement of the skull with stretched overlying skin measuring about 7.8X7.4X10.7 cm along its maximal dimensions.Prominent overlying extra-axial CSF spaces. The brainstem & the cerebellum are within normal. No gross facial anomaly. The visualized spine was unremarkable. no protruding meningoceles. Lung parenchyma is homogeneous without masses or effusions. Liver and spleen are normal in size & contour.  A fluid-filled stomach and bladder present. Central cord insertion was normal.

Case Discussion

Fetal MRI consistent with a meningoencephalocele.

Meningoencephalocele is herniation of the brain tissue and overlying meninges through a defect in the cranium. 

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