Prenatal MRI diagnosis and postnatal management of interhemispheric cysts associated with corpus callosum dysgenesis: case series and systematic review.

PURPOSE: This study presents a case series of two neonates with interhemispheric cysts and corpus callosum dysgenesis, complemented by a systematic review of 48 cases, to characterize prenatal MRI features and their correlations with postnatal imaging findings and surgical outcomes.

METHODS

Two neonates were prenatally diagnosed with interhemispheric cysts. In both cases, postnatal imaging was performed, followed by implantation of a cystoperitoneal shunt (CPS). We conducted a systematic review of 48 cases to analyze the imaging findings, associated anomalies, and surgical outcomes.

RESULTS

Prenatal MRI revealed interhemispheric cysts, colpocephaly, and corpus callosum dysgenesis in both cases, with progressive cyst enlargement during gestation. These findings were confirmed by postnatal imaging. CPS implantation reduced intracranial pressure but was associated with complications such as shunt blockage and increased cyst size. Complications were more common in patients with complex cyst morphology on MRI. Endoscopic cystoventriculostomy showed better outcomes for multiseptate cysts, whereas shunt-based procedures were associated with more complications but remained necessary in complex or refractory cases.

CONCLUSION

Prenatal MRI is invaluable for the early detection of interhemispheric cysts and corpus callosum dysgenesis, enabling tailored postnatal intervention. Although CPS is effective in managing hydrocephalus, endoscopic cystoventriculostomy may offer better outcomes in reducing cyst size and preventing recurrence. This study underscores the importance of integrating prenatal imaging into clinical practice to optimize surgical planning and improve long-term neurodevelopmental outcomes.