title: Prenatal MR imaging features of isolated cerebellar haemorrhagic lesions.
abstract: OBJECTIVE
  Prenatal features of isolated cerebellar haemorrhagic lesions have not been sufficiently characterised. We aimed to better define their MR imaging characteristics, documenting the location, extension, evolution stage and anatomic sequelae, and to better understand cerebellar haemorrhage pathophysiology.
  
  
  METHODS
  We screened our foetal MR imaging database (3200 cases) for reports of haemorrhagic lesions affecting only the cerebellum (without any supratentorial bleeding or other clastic lesions), defined as one of the following: T2-weighted hypointense or mixed hypo-/hyperintense signal; rim of T2-weighted hypointense signal covering the surface of volume-reduced parenchyma; T1-weighted hyperintense signal; increased DWI signal.
  
  
  RESULTS
  Seventeen cases corresponded to the selection criteria. All lesions occurred before the 26th week of gestation, with prevalent origin from the peripheral-caudal portion of the hemispheres and equal frequency of unilateral/bilateral involvement. The caudal vermis appeared affected in 2/3 of cases, not in all cases confirmed postnatally. Lesions evolved towards malformed cerebellar foliation. The aetiology and pathophysiology were unknown, although in a subset of cases intra- and extracranial venous engorgement seemed to play a key role.
  
  
  CONCLUSIONS
  Onset from the peripheral and caudal portion of the hemispheres seems characteristic of prenatal cerebellar haemorrhagic lesions. Elective involvement of the peripheral germinal matrix is hypothesised.
  
  
  CONCLUSIONS
  • The cerebellum can be vulnerable to bleeding during foetal development. • Isolated cerebellar haemorrhages can be seen on prenatal MRI. • In our cohort, isolated foetal cerebellar haemorrhages occurred before the 26th gestational week. • Haemorrhagic lesions happening in utero could look like malformations on post-natal MRI. • Venous engorgement could have a role in causing cerebellar haemorrhagic lesions.
authors.affiliation: Radiology Department, Ospedale Maggiore della Carità, Corso Mazzini 18, 28100, Novara, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Martino
authors.affiliation: Neonatal Intensive Care Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, 16148, Genoa, Italy. mmalova@libero.it.
authors.forename: Mariya
authors.initials: M
authors.lastname: Malova
authors.affiliation: Radiology and Neuroradiology Department, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cesaretti
authors.affiliation: Radiology and Neuroradiology Department, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Parazzini
authors.affiliation: Radiology and Neuroradiology Department, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Doneda
authors.affiliation: Neonatal Intensive Care Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, 16148, Genoa, Italy.
authors.forename: Luca A
authors.initials: LA
authors.lastname: Ramenghi
authors.affiliation: Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, 16148, Genoa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Radiology and Neuroradiology Department, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Righini
mesh_terms: D000293:Adolescent; D000328:Adult; D002526:Cerebellar Diseases / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D012189:Retrospective Studies
keywords: Cerebellar cortex; Cerebellum; Haemorrhage; Magnetic resonance imaging; Prenatal diagnosis