The clinical significance of fetal isolated cerebral borderline ventriculomegaly: report of 31 cases and review of the literature

Objective To assess the clinical significance of fetal isolated borderline cerebral lateral ventriculomegaly defined as a width of the atrium of the l ateral cerebral ventricles of 10-15 mm in the absence of other sonographica lly demonstrable malformations. Design Retrospective study of the outcome of fetuses with a sonographic dia gnosis of isolated borderline cerebral lateral ventriculomegaly and review of the English-language literature. Results Of 31 fetuses, two had chromosomal aberrations (trisomy 21 and tris omy 13) and three had neurological complications (one infant developed shun t-dependent hydrocephalus, one lissencephaly and one cerebral hemorrhage an d periventricular leukomalacia). The literature search revealed eight indep endent studies. Including the present series, 234 cases were available for analysis. An abnormal outcome was documented in 22.8% of cases. Perinatal d eath occurred in 3.7%. Chromosomal aberrations, mostly trisomy 21, were pre sent in 3.8%, malformations undetected at a second-trimester sonogram in 8. 6% and neurological sequelae, mostly a mild to moderate delay in cognitive and/or motor development, were present in 11.5%. The risk of an abnormal ne urological outcome was increased in females versus males (22.6% versus 4.6% , relative risk 4.892; 95% confidence interval 1.356-17.656), when the atri al width was 22 mm or more (13.9% versus 3.8%, relative risk 3.6, 95% confi dence interval 1.035-12.846) and when the diagnosis was made in the second trimester versus later in gestation. Conclusions In most cases, isolated borderline cerebral lateral ventriculom egaly has no consequence. However, this finding carries an increased risk o f cerebral maldevelopment, delayed neurological development and, possibly, chromosomal aberrations. The optimal management of these cases remains unce rtain.