[Rhombencephalosynapsis : a rare cerebellar malformation not to miss].

Abstract

Rhombencephalosynapsis (RS) is a rare cerebellar malformation characterized by the association of partial or total vermis agenesis and fusion of the cerebellar hemispheres. This malformation is often associated with supratentorial cerebral abnormalities and more rarely with extra-cranial abnormalities. The severity of the clinical manifestations and the prognosis of RS depend on the findings of the posterior fossa and the associated anomalies. This clinical case presents an isolated complete RS, documented by antenatal ultrasound, fetal and postnatal/mortem magnetic resonance imaging (MRI) and pathological examination. A RS should be suspected on antenatal morphological ultrasound in case of reduction in size of the posterior fossa and in the absence of vermis. Fetal MRI is the imaging modality of choice to confirm the diagnosis. In the event of medical termination of pregnancy, the autopsy is rarely accepted by the parents, limiting postnatal investigations. This is why postnatal/postmortem MRI can prove to be an alternative to confirm and better document this rare pathology. Finally, multidisciplinary collaboration is essential to make the diagnosis and to ensure the best care.