PERINATAL ULTRASONOGRAPHY AND MAGNETIC-RESONANCE-IMAGING FINDINGS IN CONGENITAL HYDROCEPHALUS ASSOCIATED WITH FETAL INTRAVENTRICULAR HEMORRHAGE

OBJECTIVE: We present the case histories of three premature infants wi th congenital posthemorrhagic hydrocephalus. STUDY DESIGN: The timing of the lesion was monitored in utero in two of the three cases. Magnet ic resonance imaging studies (prenatal in one case, within 24 hours of birth in all three cases) established the duration of the lesions and thereby added to the ultrasonographic findings, RESULTS: All three pa tients demonstrated a similar pattern of lesions, consisting of (1) un ilateral germinal matrix hemorrhage with cystic resorption, (2) residu al blood in the cerebrospinal fluid with a ''granular'' ependymal reac tion, (3) asymmetric ventriculomegaly predominating on the side of the hemorrhage with mild atrophy and periventricular cysts, and (4) parti al hypoplasia of the ipsilateral thalamus. On the basis of two cases i n which information about the pregnancy was available and in which fet al oligohydramnios without ruptured membranes was detected, we assume that this pattern of lesions may have resulted from a hypoxic-ischemic episode followed by intraventricular hemorrhage. CONCLUSIONS: Because these three infants with congenital hydrocephalus were born during a period of only 18 months in a perinatal center serving a region with 1 6,000 live births per year, we speculate that a posthemorrhagic cause for congenital hydrocephalus underestimated.