Summary
A case of parabiotic twin pregnancy is described with early fetal co-twin loss and topical isocortical disruption and gastroschisis in the surviving twin. We conclude from this case that early fetal parabiotic twin syndrome (before 16 weeks of gestational age) may cause microgyria and neuronal heterotopia. The cerebral and extracranial findings can be explained as the result of multiple vascular obstructions. Whereas most cases of parabiotic twin syndrome with brain damage involve cystic necrosis, focal hypoplasia with disrupted development in the affected part has been found in the present case. The probable reason in discussed. The roentgenographic analysis of the dead twin fetus is consistent with the period of 13–16 weeks as the likely period in which microgyria and neuronal heterotopia originated in the surviving twin. The present case constitutes one of the rare instances in which neuronal migration disturbance in the human could be dated reliably.
References
Aicardi J, Goutières F, Hodebourg de Verbois A (1972) Multicystic encephalomalacia of infants and its relation to abnormal gestation and hydranencephaly. J Neurol Sci 15:357–373
Barth PG (1984) Prenatal clastic encephalopathies. Clin Neurol Neurosurg 86:65–75
Benirschke K (1961) Twin placenta in perinatal mortality. New York State J Med 61:1499–1508
Brocher JEW (1932) Polyporencephalie. Zentralbl Ges Neurol Psychiatr 142:107–119
Campbell S, Newman G (1971) Growth of the fetal biparietal diameter during normal pregnancy. J Obstet Gynaecol Br Commonw 78:513–519
Dekaban A (1965) Large defects in cerebral hemispheres associated with cortical dysgenesis. J Neuropathol Exp Neurol 24:512–530
Durkin MV, Kaveggia EG, Pendleton E, Neuhäuser G, Opitz JM (1976) Analysis of etiologic factors in cerebral palsy with severe mental retardation. I. Analysis of gestational, parturitional and neonatal data. Eur J Pediatr 123:67–81
Dvorák K, Feit J (1977) Migration of neuroblasts through partial necrosis of the cerebral cortex in newborn rats. —Contribution to the problems of morphological development and developmental period of cerebral microgyria. Acta Neuropathol (Berl) 38:203–212
Dvořák K, Feit J, Juránkova Z (1978) Experimentally induced focal microgyria and status verrucosus deformis in rats —Pathogenesis and interrelation histological and autoradiographical study. Acta Neuropathol (Berl) 44:121–129
Galea P, Scott JM, Goel KM (1982) Feto-fetal transfusion syndrome. Arch Dis Child 57:781–783
Gosseye S, Golaire M-C, Larroche J-Cl (1982) Cerebral, renal and splenic lesions due to fetal anoxia and their relationship to malformations. Dev Med Child Neurol 24:510–518
Hoyme HE, Higginbottom MC, Jones KL (1981) The vascular pathogenesis of gastroschisis: Intrauterine interruption of the omphalomesenteric artery. J Pediatr 98:228–231
Jeanty P, Rodesch F, Delbeke D, Dumont JE (1984) Estimation of gestational age from measurements of fetal long bones. J Ultrasound Med 3:75–79
Jones KL, Benirschke K (1983) The developmental pathogenesis of structural defects: the contribution of monozygotic twins. Semin Perinatol 7:239–243
Jung IH, Graham JM, Schultz N, Smith DW (1984) Congenital hydranencephaly/porencephaly due to vascular disruption in monozygotic twins. Pediatrics 73:467–469
Kaplan HA, Ford DH (1966) The brain vascular system, Sect I: Embryology of the vascular system. Elsevier, Amsterdam London New York, pp 6–40
Levine DN, Fisher MA, Caviness VS Jr, (1974) Porencephaly with microgyria: A pathologic study. Acta Neuropathol (Berl) 29:99–113
Lyon G, Robain O (1967) Etude comparative des encéphalopathies circulatoires prénatales et para-natales (hydranencéphalies, porencéphalies et encéphalomalacies kystiques de la substance blanche). Acta Neuropathol (Berl) 9:79–98
McBride MC, Kemper TL (1982) Pathogenesis of four-layered microgyric cortex in man. Acta Neuropathol (Berl) 75: 93–98
Moore CM, McAdams AJ, Sutherland J (1969) Intrauterine disseminated intravascular coagluation: A syndrome of multiple pregnancy with a dead twin fetus. J Pediatr 74:522–528
Naeye RL (1965) Organ abnormalities in a human parabiotic syndrome. Am J Pathol 46:829–842
Reisman LE, Pathak A (1966) Bilateral renal cortical necrosis in the newborn. Am J Dis Child 111:541–543
Schultz DM, Giordano DA, Schultz DH (1962) Weights of organs of fetuses and infants. Arch Pathol 74:244–250
Sidman RL, Rakic P (1973) Neuronal migration with special reference to developing human brain: A review. Brain Res 62:1–35
Spranger J, Benirschke K, Hall JG, Lenz W, Lowry RB, Opitz JM, Pinsky L, Schwarzacher HG, Smith DW (1982) Errors of morphogenesis: concepts and terms. J Pediatr 100:160–165
Yoshioka H, Kadumoto Y, Mino M, Morikawa Y, Kasabuchi Y, Kusunoki T (1979) Multicystic encephalomalacia in liverborn twin with a stillborn macerated co-twin. J Pediatr 96:798–800
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Barth, P.G., van der Harten, J.J. Parabiotic twin syndrome with topical isocortical disruption and gastroschisis. Acta Neuropathol 67, 345–349 (1985). https://doi.org/10.1007/BF00687825
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00687825