| Unusual presentation of fetal ventriculomegaly: a case report |
Sang Yoon Lee 
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Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea |
Correspondence:
Sang Yoon Lee, Tel: 82-53-200-5704, Fax: 82-53-425-6683, Email: gguggusy@gmail.com
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Received: 10 July 2024 • Revised: 9 August 2024 • Accepted: 4 September 2024 |
| Abstract |
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Fetal ventriculomegaly (VM) is a relatively common finding during prenatal examinations and occurs in approximately 0.2% of live births. Although there are various causes, obstructive VM due to cerebellar hemorrhage is exceedingly rare. A 33-year-old primigravida presented at 32 weeks of gestation with VM. At 36 weeks of age, a male infant was delivered via cesarean section. Postnatal imaging revealed severe bilateral hydrocephalus and space-occupying lesions in the cerebellum. Initial concerns about a potential germ cell tumor were raised due to elevated alpha-fetoprotein levels in both serum and cerebrospinal fluid. An external ventricular drain was placed to manage obstructive hydrocephalus. When the baby was 1 month old, surgical exploration revealed an old blood clot without any evidence of a tumor. Histopathological examination confirmed an old hemorrhage with no malignant cells. This case underscores the diagnostic challenges in distinguishing between hemorrhages and tumors in the context of fetal VM. Despite elevated alpha-fetoprotein levels, no tumors were identified. The underlying cause of cerebellar hemorrhage remains unclear despite extensive workups. Nevertheless, this case report details multifaceted diagnostic efforts to address the rare occurrence of cerebellar hemorrhage related to fetal VM, leading to a comprehensive case presentation. |
| Key Words:
Fetal cerebral ventriculomegaly, Alpha-fetoprotein, Neoplasms, germ cell and embryonal, Intracranial hemorrhages |
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