Congenital subependymal pseudocysts: Own data and meta-analysis of the literature

Background: Congenital subependymal pseudocysts are incidental findings tha t are round in 0.5-5.2% of neonates during postmortem examination or head u ltrasonography. In our institution we detected 10 neonates with CSEPC, Objective: To investigate associated etiological factors, morphologic chara cteristics and outcome of CSEPC, Methods: We performed a mete-analysis of the literature on CSEPC (1967-98), including our 10 cases. Results: A total of 256 cases of CSEPC were analyzed. Ultrasound diagnosed 77.6% of CSEPC; 48.8% were bilateral and 53.4% were located in the caudotha lamic groove or head of caudate nucleus. Altogether, 93.5% resolved during 1-12 months of ultrasonographic follow-up. Compared to the general neonatal population, the following features were more prevalent in the CSEPC popula tion: prematurity, maternal Vaginal bleeding, preeclamptic toxemia, intraut erine growth restriction, asphyxia, fetal cytomegalovirus and rubella infec tions, congenital malformations, chromosomal aberrations, infant mortality, and neurodevelopmental handicap. The risk for neurodevelopmental handicap was significantly higher when CSEPC were associated with fetal infections, IUGR, malformations and chromosomal aberrations, or persistence of CSEPC du ring follow-up, CSEPC infants without any of these four conditions had a lo w risk for neurodevelopmental handicap, Conclusions: CSEPC are morphologic features of various underlying condition s encountered in the fetus, Association of CSEPC with IUGR, fetal infection s, malformations and chromosomal aberrations or persistence of CSEPC indica tes a higher risk for future neurodevelopmental handicaps, probably because of the deleterious effects on the fetal brain that are inherent in these c onditions. A favorable outcome is expected in the absence of these risk fac tors.