Novel neuropathology in fetal alcohol syndrome

Behavioral, imaging, and epidemiologic data on Fetal Alcohol Syndrome (FAS) are abundant, as are data in experimental animal models. By contrast, brain tissue studies in human FAS are scarce. From the files at our institutions we found 10 cases with maternal alcohol histories and neuropathology (NP) slides. Subjects lived <1d‐22mos; 7 were premature. 6 were growth‐restricted; 3 had microcephaly; 9 had facial features of FAS; 8 had major systemic anomalies. Novel NP findings include: A) disturbances of neuronal migration/organization in 7, e.g. columnar (“fetal”) cortex and dentate gyrus abnormalities; B) hypoxic‐ischemic lesions in 3, e.g. white matter damage, germinal matrix hemorrhage, mineralization, neuronal loss, and gliosis of gray matter; C) lesions of uncertain pathogenesis in 3, such as decreased white matter volume and hypomyelination, patchy internal granule cell hypodensity, and arcuate nucleus hypoplasia. The findings expand upon those seen in the meager human literature to date, and assist in understanding the neurologic deficits in FAS.