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Polymicrogyria in a patient after twin–twin transfusion syndrome
  1. Eva Karner1,
  2. Gregor J Kasprian2,
  3. Alex Farr1 and
  4. Elisabeth Krampl-Bettelheim1
  1. 1Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Wien, Austria
  2. 2Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Wien, Austria
  1. Correspondence to Professor Alex Farr; alex.farr{at}


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.

  • neonatal and paediatric intensive care
  • pregnancy
  • neonatal intensive care
  • materno-fetal medicine
  • neonatal health

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  • Contributors EK and EK-B were responsible for drafting of the text, sourcing and editing of clinicalimages, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. All authors gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.