Ritsuko K Pooh*
The prevalence of cerebral palsy has not decreased despite major improvements in clinical care in antenatal/
neonatal period as well as intrapartum period. In about 70% of cases, cerebral palsy results from events occurring
before birth that can disrupt normal development of the brain. The antepartum risk factors should include fetal brain
mal development and intrauterine brain injuries, which are unclassifiable into congenital brain anomalies and may exist
inconspicuously during pregnancy and even after birth. Especially, neuronal migration disorder and acquired brain
damage in utero should be responsible for postnatal neurological impairment. Imaging technologies including three
dimensional ultrasound have been remarkably improved and contributed to prenatal evaluation of fetal Central Nervous
System (CNS) development and assessment of CNS abnormalities in utero. In this article, objective and precise imaging
diagnoses of fetal CNS including migration disorders and acquired brain damages. Furthermore, 3D bidirectional power
Doppler angiography has depicted fine cerebral vessels of medullary veins which may relate with timing of insult as well
as with postnatal neurological prognosis. It is promising to clarify the developmental mechanism of CNS damages with
advanced ultrasound diagnostic techniques in the near future. Postnatal unexplained neurological deficits may strongly
relate with intrauterine brain development therefore fetal neurology has great responsibility and an important role in
perinatal medicine.
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