Wednesday, April 11, 2012

OB/GYN: malformations

so.  I know i've made the sad parts of ob/gyn obvious.  But I have followed up on one of the babies born without a right ear.  I wasn't allowed to take a picture, because she has other malformations and the parents didn't want her seen as a freak.  So I will just tell you about her.  She has a cleft lip and palate. Her head shape is just a little too round and her right jaw is obviously smaller than her left side.  The chromosome typing hasn't come back yet.  I am doubting it is any chromosome problem since its not on both sides, but then i guess what happens in books isn't always what happens in real life.  The only other way she could have gotten this way is if the mom had ingested something toxic to the developing fetus. Any illegal drug will do or a few different kinds of actual medications. But mom of course denies these possibilities. 

Anyhow, what I am able to show is her MRIs.  You can see that she has a big malformation in the bottom part of her brain where her cerebellum would be.  This congential lack of cerebellum is called dandy-walker syndrome.  In most cases, it refers to a complete absence of the middle of the cerebellum called the vermis.  When this happens, the person is usually just fine and develops normally.  Our path teacher once said, "i walk just dandy without my vermis."   But her malformation isn't just the vermis, its the whole cerebellum is smaller than it should be.  See the black triangle at the bottom of this picture. That black shows empty space and just so you know, there shouldn't be just empty space in the brain like that. If you refer to some of those neuro pictures from way back when i'm sure you can compare for yourself.

This picture here, is the more standard MRI. Here not only can you see the cerebellum problems but you can also see the shape of her head. The weird jaw line.  You can see that she has neonatal teeth (most babies aren't born with teeth).  You can see that her eye sockets are smaller than normal and even her brain tissue just isn't quite right.  You can  see the palate malformation as well. 

Alright here i'll insert a labelled pic.  Its not terribly obvious but its the best i can do for now.


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