Cerebral artery reverse flow as an indicator of critical intracranial hypertension in fetal intracranial hemorrhage: Case report.

Abstract

Objective: Intracranial hemorrhage (ICH) is a rare serious fetal event. It manifests via non-specific sonographic findings such as: ventriculomegaly, increased periventricular echogenity, hyperechogenic ependyma and presence of avascular intracranial masses. Severe ICH causes an increase in fetal intracranial pressure, which can be quantified in utero by the presence of reverse flow in the middle cerebral artery (MCA-REDF). Retrograde flow in the middle cerebral artery indicates already deteriorating circulatory conditions in the fetal brain with loss of autoregulatory mechanisms and critical damage to the vascular supply. Detection of this finding allows to improve the diagnosis of ICH and also affects the prognosis and management of pregnancy. We report the case of critical intracranial hypertension in fetal intracranial hemorrhage manifested by cerebral artery reverse flow.