Mild Ventriculomegaly, Ventricular Asymmetry, and Posterior Fossa Variants: A Narrative Review of Borderline Fetal Brain Findings.
- 1Obstetrics and Gynecology I, Mother and Child Department, University of Medicine and Pharmacy "Iuliu Hațieganu", 400006 Cluj-Napoca, Romania.
- 2Obstetrics Gynecology I, Emergency County Hospital, 400006 Cluj-Napoca, Romania.
- 3Department of Internal Medicine, Medical Clinic I-Internal Medicine, Cardiology and Gastroenterology, University of Medicine and Pharmacy "Iuliu Hațieganu", 400006 Cluj-Napoca, Romania.
Abstract
Recent advances in fetal neurosonography have markedly improved the detection of subtle central nervous system findings that were previously identified less frequently. Mild ventriculomegaly (MV), non-dilated ventricular asymmetry (NDVA), mega cisterna magna (MCM), and Blake's pouch cyst (BPC) are increasingly encountered during routine prenatal ultrasound and, in the absence of associated genetic or infectious abnormalities, are commonly regarded as borderline conditions or anatomical variants. These findings frequently pose challenges in prognostic evaluation and in the counseling of expectant parents. The objective of this review is to summarize current evidence on the detection, characterization, and clinical management of these four entities and to provide a practical framework for evidence-based parental counseling. This narrative review examines the diagnostic approach to MV, NDVA, MCM, and BPC using both ultrasound and fetal magnetic resonance imaging (MRI). A uniform analytic framework is applied to each entity, addressing in turn etiology, sonographic assessment, the complementary role of MRI, genetic evaluation, and prognosis with counseling considerations. Representative ultrasound and fetal MRI images from a tertiary referral center are used for illustrative purposes. Across all four entities, fetal MRI provides complementary information in selected cases, while genetic testing and serological screening may help exclude chromosomal or infectious etiologies. Neurodevelopmental outcomes are broadly favorable when the finding is truly isolated, but the prognostic literature is limited by small samples, heterogeneous definitions of "isolated," short follow-up, and unstandardized neurodevelopmental assessments. Common themes across these entities are synthesized into a staged framework intended to support evidence-based parental counseling regarding the expected neurodevelopmental outcomes of these fetuses.
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BibTeX
@article{goidescu2026mild,
title = {{Mild Ventriculomegaly, Ventricular Asymmetry, and Posterior Fossa Variants: A Narrative Review of Borderline Fetal Brain Findings.}},
author = {Iulian Gabriel Goidescu and Georgiana Nemeti and Adelina Staicu and Mihai Surcel and Dan Boitor and Cerasela Mihaela Goidescu and Ioana Cristina Rotar and Gheorghe Cruciat and Daniel Muresan},
journal = {Diagnostics (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/diagnostics16193144},
url = {https://europepmc.org/article/MED/42882299},
note = {CC BY},
}
RIS
TY - JOUR
TI - Mild Ventriculomegaly, Ventricular Asymmetry, and Posterior Fossa Variants: A Narrative Review of Borderline Fetal Brain Findings.
AU - Iulian Gabriel Goidescu
AU - Georgiana Nemeti
AU - Adelina Staicu
AU - Mihai Surcel
AU - Dan Boitor
AU - Cerasela Mihaela Goidescu
AU - Ioana Cristina Rotar
AU - Gheorghe Cruciat
AU - Daniel Muresan
PY - 2026
DA - 2026/09/27
JO - Diagnostics (Basel, Switzerland)
DO - 10.3390/diagnostics16193144
UR - https://europepmc.org/article/MED/42882299
AB - Recent advances in fetal neurosonography have markedly improved the detection of subtle central nervous system findings that were previously identified less frequently. Mild ventriculomegaly (MV), non-dilated ventricular asymmetry (NDVA), mega cisterna magna (MCM), and Blake's pouch cyst (BPC) are increasingly encountered during routine prenatal ultrasound and, in the absence of associated genetic or infectious abnormalities, are commonly regarded as borderline conditions or anatomical variants. These findings frequently pose challenges in prognostic evaluation and in the counseling of expectant parents. The objective of this review is to summarize current evidence on the detection, characterization, and clinical management of these four entities and to provide a practical framework for evidence-based parental counseling. This narrative review examines the diagnostic approach to MV, NDVA, MCM, and BPC using both ultrasound and fetal magnetic resonance imaging (MRI). A uniform analytic framework is applied to each entity, addressing in turn etiology, sonographic assessment, the complementary role of MRI, genetic evaluation, and prognosis with counseling considerations. Representative ultrasound and fetal MRI images from a tertiary referral center are used for illustrative purposes. Across all four entities, fetal MRI provides complementary information in selected cases, while genetic testing and serological screening may help exclude chromosomal or infectious etiologies. Neurodevelopmental outcomes are broadly favorable when the finding is truly isolated, but the prognostic literature is limited by small samples, heterogeneous definitions of "isolated," short follow-up, and unstandardized neurodevelopmental assessments. Common themes across these entities are synthesized into a staged framework intended to support evidence-based parental counseling regarding the expected neurodevelopmental outcomes of these fetuses.
SN - 2075-4418
ER -