| Popis: |
Objective: The purpose of this study was to describe the relationship between intra- and extra-cranial anomalies and neurodevelopmental outcome for fetuses diagnosed with a posterior fossa anomaly (PFA) on fetal MRI.Methods: Cases of Dandy-Walker malformation (DWM), vermian hypogenesis/hypoplasia (VH), and mega cisterna magna (MCM) were identified through the Fetal Care Center of Cincinnati between January 2004 and December 2010. Parental interview and retrospective chart review were used to assess neurodevelopmental outcome. Results: PFAs were identified in 59 fetuses; 9 with DWM, 36 with VH, and 14 with MCM. Cases with isolated PFAs (14/59) had better outcomes than those with additional anomalies (p=0.00016), with isolated cases of MCM all being neurodevelopmentally typical. Cases with additional intra-cranial anomalies were more likely to have a poor outcome than those without intra-cranial anomalies (p=0.00085). The presence of extra-cranial anomalies increased the likelihood of having a poor outcome (OR=10.2, 95% CI, 2.6-40) as did the identification of an abnormal brainstem (OR=12.97, 95% CI, 2.9-58.0).Conclusion: Intra- and extra-cranial anomalies were good predictors of neurodevelopmental outcome in this study. The prognosis was poor for individuals with an abnormal brainstem while those with isolated MCM had normal neurodevelopmental outcome. |
