Polymicrogyria in a patient after twin-twin transfusion syndrome

This case report presents a patient with a monochorionic twin pregnancy, development of twin-twin transfusion-syndrome (TTTS) and polymicrogyria (PMG) of one fetus. Due to TTTS grade 3, fetoscopic laser ablation was performed at gestational week 16+1. Sonographic follow-up showed a cortical malformation of the right parietal lobe in the former donor, which was identified as PMG by MRI scans. We describe the course of the pregnancy, as well as the clinical, especially neurological, development of the child over 3 years. This case report documents the power of neuroplasticity, leading to comparably good neurological outcome in an extensive, likely acquired cortical malformation. Further, it emphasises the importance of a thorough prenatal imaging characterisation of malformations of cortical development for optimal prenatal counselling of these cases.

Automated summary

This case report presents a patient with a monochorionic twin pregnancy, development of twin-twin transfusion-syndrome (TTTS) and polymicrogyria (PMG) of one fetus. The patient underwent fetoscopic laser ablation at gestational week 16+1 due to TTTS grade 3. Sonographic follow-up revealed a cortical malformation in the former donor, identified as PMG through MRI scans. The report describes the course of the pregnancy and the clinical development of the child over 3 years, highlighting the power of neuroplasticity for a good neurological outcome despite extensive cortical malformation. Additionally, it stresses the importance of thorough prenatal imaging characterization for optimal prenatal counseling in cases of cortical developmental malformations.