TY - CHAP M1 - Book, Section TI - Intrauterine Insults: Fetal Ischemic Stroke and Intracranial Hemorrhage A1 - Malinger, Gustavo A1 - Monteagudo, Ana A1 - Pilu, Gianluigi A1 - Birnbaum, Roee A2 - Malinger, Gustavo A2 - Monteagudo, Ana A2 - Pilu, Gianluigi A2 - Paladini, Dario A2 - Timor-Tritsch, Ilan E. PY - 2023 T2 - Timor's Ultrasonography of the Prenatal Brain, 4e AB - KEY POINTSMany congenital anomalies of the brain do not derive from abnormal embryogenesis but are the consequence of destructive processes that may occur any time in gestation, particularly during the third trimester.Most of these destructive processes are the consequence of vascular accidents, hemorrhages, or occlusion. Although in many cases the etiology is unknown, evidence is rapidly growing regarding possible genetic conditions implicated in these disorders. Other etiologies to be considered are placental insufficiency, coagulation disorders, drug consumption, and transplacental infections.Fetal ischemic stroke and intracranial hemorrhage are clinically important because they may have severe consequences, but they frequently escape detection.Prenatal stroke is considered the most important determinant of cystic destruction of the cortex, depending upon the time of occurrence, and the severity may result in a spectrum of conditions that include porencephaly (single or multiple cysts replacing brain parenchyma), schizencephaly (a gray matter–lined cleft in the cerebral mantle connecting the cavity of lateral ventricles to the subarachnoid space), and hydranencephaly (complete destruction of the cerebral hemispheres).Intracranial hemorrhage is probably the most common and therefore the best known of all intrauterine disruptions of the fetal brain. The hemorrhage occurs usually into the lateral ventricles, and the sonographic picture changes with time. An echogenic collection is first seen, and in the following days it develops into a complex mass frequently complicated by severe ventriculomegaly.Cerebellar lesions are discussed separately since the prenatal differentiation between stroke and hemorrhage, although problematic, has similar effects. SN - PB - McGraw Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1194720471 ER -