[Diagnosis of subependymal cysts by brain ultrasound].
OBJECTIVE
The aim of this study was to describe the clinical data and sonographic evolution of subependymal cysts (SEC) and to compare alone SEC versus SEC combined with other brain abnormalities.


METHODS
The diagnosis of SEC relied on the discovery of one/several cysts at the outer angle of one/both lateral ventricles detected by routine brain ultrasound tests in the first days of life. During the 1981-2000 period, 66 neonates had evidence of SEC in Port-Royal Department of Neonatal Medicine. The cases were divided into two groups: G-I, alone SEC; G-II, SEC combined with other brain abnormalities. Hospital charts were reviewed for gestational and delivery data and ultrasound scans were analyzed according to a preset list of items (dates, measurements, other findings).


RESULTS
Patients with alone SEC had a higher gestational and birthweight, better birth conditions, and less respiratory morbidity. High rates of associated congenital anomalies were observed in both groups (19% in G-I, 13% in G-II, NS). Rare pre/perinatal infections did not show any association with SEC. SEC were uni or bilateral, single or multiple (string), with no difference between G-I and G-II. Unilateral SEC predominated in the left side (26/28, P<0.01). Serial examinations were carried out in 49/66 (74%), showing an increase in size of SEC in 21/49 (45%) in the first month of life, while 12 SEC (24%) disappeared. The 11 deaths occurred in neonates with other severe brain injuries (five peri-intraventricular hemorrhages, four periventricular leukomalacias) except one (diaphragmatic hernia).


CONCLUSIONS
Alone SEC and SEC combined with other brain abnormalities follow the same morphologic pattern and evolution. The striking predominance in the left side may suggest another etiology. Both are in favor of a developmental deviation and not a viral fetopathy.
Fekete
Saskia M W
SM
Pediatria, Universidade Estadual Paulista, Botucatu, SP. wiegfekete@uol.com.br
Monset-Couchard
Michèle
M
Rugolo
Lígia S de S
LS
de Bethmann
Odile
O
Crocci
Adalberto José
AJ