description
congenital intracranial tumours are very rare. they may arise from embryonic (teratoma, dermoid), germ cell (germinoma), neural (medulloblastoma), or ependymal (choroid plexus papilloma, astrocytoma) tissue. they may be associated with genetic diseases such as tuberous sclerosis, neurofibromatosis and von hippel lindau syndrome. the majority of intracranial tumours are supratentorial and teratomas are the commonest.
diagnosis
there is marked destruction and distortion of normal brain architecture by a cystic, solid or mixed echogenic mass. there may be associated calcification. hydrocephaly frequently accompanies intracranial tumours, due to obstruction of the ventricular system and may be the first sign of an intracranial neoplasm. serial scans often show rapid growth of the tumour and macrocephaly may be evident. polyhydramnios after twenty weeks gestation is common. distinction between the different tumours is unlikely to be made by ultrasound.
differential diagnosis
intracranial haemorrhage is the main differential diagnosis in the presence of an intracranial mass with solid and cystic elements . serial scans, however, would show no further growth in the lesion, and in time cystic change would become evident.
sonographic features
irregular echogenic mass with cystic or solid areas and loss of normal brain architecture.
ventriculomegaly is frequently associated.
macrocephaly may be seen.
polyhydramnios commonly seen after twenty weeks gestation.
associated syndromes
references
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