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The widened frontal subarachnoid space. A CT comparative study between macrocephalic, microcephalic, and

J C Odita1

  • 1Department of Radiology, Hamad Medical Corporation, Doha, Qatar.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|February 1, 1992
PubMed

Insights

Frontal subarachnoid space widening in children is often not linked to macrocephaly. This finding suggests it may be a normal developmental variation, not necessarily external hydrocephalus.

Area of Science:

  • Pediatric Radiology
  • Neuroimaging
  • Developmental Pediatrics

Background:

  • Frontal subarachnoid space widening is a radiologic finding observed in pediatric computed tomographic (CT) scans.
  • This finding has been anecdotally associated with macrocephaly in children.

Purpose of the Study:

  • To retrospectively evaluate the association between frontal subarachnoid space widening and macrocephaly in pediatric patients.
  • To determine if clinical and radiologic characteristics differ between macrocephalic and normocephalic/microcephalic children with this finding.

Main Methods:

  • Retrospective review of CT head scans from 67 infants and children with frontal subarachnoid space widening over a 5-year period.
  • Analysis of patient cohorts based on head circumference (macrocephalic, normocephalic, microcephalic).
  • Comparison of clinical and radiologic features across these groups.

Main Results:

  • Macrocephaly was present in only 22.3% of the studied patients.
  • No significant differences were found in clinical or radiologic characteristics between macrocephalic and normocephalic/microcephalic children with frontal subarachnoid space widening.
  • The association between this radiologic sign and macrocephaly may be overemphasized.

Conclusions:

  • Frontal subarachnoid space widening in children might represent a normal developmental variation with transient cerebrospinal fluid accumulation.
  • The term "external hydrocephalus" may be inappropriate without significant ventricular enlargement or signs of increased intracranial pressure.
  • This finding warrants a re-evaluation of its diagnostic significance in the absence of other pathological indicators.

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