Brain development anomalies detected during pregnancy may signal underlying neurological conditions that could affect lifelong cognitive function and quality of life. Understanding these early warning signs helps families make informed decisions and prepare for potential interventions. A comprehensive analysis of fetal brain scans has revealed four distinct patterns of lateral ventricular border irregularities that can be detected through prenatal ultrasound and MRI. These abnormalities affect the fluid-filled spaces within the developing brain and appear as protrusions, indentations, undulations, or mixed configurations along the ventricular walls. Among 66 examined cases, nodular protrusions represented the most common pattern, occurring in nearly 29% of cases and strongly correlating with neuronal migration disorders including periventricular nodular heterotopia and tuberous sclerosis complex. Non-nodular protrusions, while less frequent, were linked to brain injuries from hemorrhage or cytomegalovirus infections during pregnancy. The classification system enables more precise prenatal counseling by connecting specific imaging patterns to known neurological conditions. This diagnostic framework represents a significant advance in fetal neurology, moving beyond simple detection of abnormalities toward pattern-based prediction of underlying causes. However, the study's retrospective design and relatively small sample size limit definitive prognostic value. The 50% pregnancy termination rate reflects the severity of associated conditions, while the 42% live birth rate demonstrates that some irregularities may be compatible with survival. Long-term neurodevelopmental outcomes for affected children remain variable and require extended follow-up studies to establish clearer prognostic indicators.