title: Mid-hindbrain malformations due to drugs taken during pregnancy.
abstract: Although genetic defects are the leading cause of central nervous system malformations including in the posterior fossa, specific malformative patterns should alert the clinician to consider rather a teratogenic etiology. We discuss the imaging features of 2 mid-hindbrain malformations consecutive to the intake of isotretinoin (Roaccuatane®; case 1) and misoprostol (Cytotec®; case 2) during pregnancy and review the pertinent literature. We correlate the morphological appearance of the mid-hindbrain malformation, as seen on high-resolution magnetic resonance imaging to possible drug-induced pathogenetical mechanisms. The recognition of characteristic imaging patterns enables diagnosis of and/or confirmation of suspected drug-induced hindbrain malformations. This has important medicolegal implications and also clinical significance to avoid unsuccessful and misleading genetic testing.
authors: 1Department of Radiology, Unit of Pediatric Radiology, Geneva University Hospital, Geneva, Switzerland.
authors: Laura
authors: L
authors: Merlini
authors: Joël
authors: J
authors: Fluss
authors: Amira
authors: A
authors: Dhouib
authors: Maria I
authors: MI
authors: Vargas
authors: Minerva
authors: M
authors: Becker
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000473:pathology*; D003879:Dermatologic Agents / Q000009:adverse effects; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D015474:Isotretinoin / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D016595:Misoprostol / Q000009:adverse effects; D010120:Oxytocics / Q000009:adverse effects; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000473:pathology*; D012249:Rhombencephalon / Q000002:abnormalities* / Q000187:drug effects
chemical_list: D003879:Dermatologic Agents; D010120:Oxytocics; D016595:Misoprostol; D015474:Isotretinoin
keywords: brain magnetic resonance imaging; mid-hindbrain malformations; pregnancy; teratogen