title: Neurodevelopment outcome of newborns with cerebral subependymal pseudocysts at 18 and 46 months: a prospective study.
abstract: OBJECTIVE
  Subependymal pseudocysts (SEPC) are cerebral periventricular cysts located on the floor of the lateral ventricle and result from regression of the germinal matrix. They are increasingly diagnosed on neonatal cranial ultrasound. While associated pathologies are reported, information about long-term prognosis is missing, and we aimed to investigate long-term follow-up of these patients.
  
  
  METHODS
  Newborns diagnosed with SEPC were enrolled for follow-up. Neurodevelopment outcome was assessed at 6, 18 and 46 months of age.
  
  
  RESULTS
  74 newborns were recruited: we found a high rate of antenatal events (63%), premature infants (66% <37 weeks, 31% <32 weeks) and twins (30%). MRI was performed in 31 patients, and cystic periventricular leukomalacia (c-PVL) was primarily falsely diagnosed in 9 of them. Underlying disease was diagnosed in 17 patients, 8 with congenital cytomegalovirus (CMV) infection, 5 with genetic and 4 with metabolic disease. Neurological examination (NE) at birth was normal for patients with SEPCs and no underlying disease, except one. Mean Developmental Quotient and IQ of these patients was 98.2 (±9.6SD; range 77-121), 94.6 (±14.2SD; 71-120) and 99.6 (±12.3SD; 76-120) at 6, 18 and 46 months of age, respectively, with no differences between the subtypes of SEPC. A subset analysis showed no outcome differences between preterm infants with or without SEPC, or between preterm of <32 GA and ≥32 GA.
  
  
  CONCLUSIONS
  Neurodevelopment of newborns with SEPC was normal when no underlying disease was present. This study suggests that if NE is normal at birth and congenital CMV infection can be excluded, then no further investigations are needed. Moreover, it is crucial to differentiate SEPC from c-PVL which carries a poor prognosis.
authors.affiliation: Department of Pediatrics and Pediatric Surgery, Follow up Unit, Clinic of Neonatology, University Hospital Center and University of Lausanne, Lausanne, Vaud, Switzerland.
authors.forename: Manon
authors.initials: M
authors.lastname: Cevey-Macherel
authors.forename: Margarita
authors.initials: M
authors.lastname: Forcada Guex
authors.forename: Myriam
authors.initials: M
authors.lastname: Bickle Graz
authors.forename: Anita C
authors.initials: AC
authors.lastname: Truttmann
mesh_terms: D001927:Brain Diseases / Q000151:congenital* / Q000000981:diagnostic imaging; D002675:Child, Preschool; D003560:Cysts / Q000151:congenital* / Q000175:diagnosis / Q000000981:diagnostic imaging; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D011379:Prognosis; D011446:Prospective Studies; D014463:Ultrasonography
keywords: Germinolytic cyst; Imaging; Neonatology; Neurodevelopment; Subependymal pseudocyst