Skew ocular deviation: A catastrophic sign on MRI of fetal glioblastoma

Yu Ming Chuang, Wan Yuo Guo, Donald Ming Tak Ho, Tai-Tong Wong, Jeng Hsiu Hung, Shu Jen Chen, Ming Huei Sheu, Cheng Yen Chang

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)


Case Report: We report the prenatal observation of fetal ocular skew deviation in a case of a glioblastoma found prenatally at 33 weeks' gestation by MRI. The fetal MRI, obtained by half-Fourier single-shot turbo spin echo (HASTE) pulse sequences, showed a tumor (80 mm in maximum diameter) in the right deep cerebral hemisphere with extension to the mid-cranial fossa and tentorial hiatus in addition to severe hydrocephalus. On coronal MR images a vertical dysconjugated gaze was recognized. One week after the MRI, frequent delayed deceleration prompted an emergency cesarean section. The baby was born with left hemiparesis and central neurogenic hyperventilation, which evolved into decerebrate rigidity and apneustic breathing within 2 h. Postmortem examination revealed a glioblastoma in the right deep hemisphere, a tumor with brain stem involvement, and transtentorial herniation. Conclusions: We suggest, therefore, that recognition of ocular skew deviation on fetal MR images would indicate brain stem involvement and poor postnatal prognosis. Early recognition of the catastrophic sign would lead to proper management.

Original languageEnglish
Pages (from-to)371-375
Number of pages5
JournalChild's Nervous System
Issue number5-6
Publication statusPublished - Jun 1 2003
Externally publishedYes


  • Congenital brain tumor
  • Fetal MR
  • Glioblastoma
  • Skew deviation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology


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