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External hydrocephalus in small children

Raj Kumar1

  • 1Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, UP, India. rajkumar@sgpgi.ac.in

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|March 24, 2006
PubMed

Insights

External hydrocephalus diagnosis can be challenging due to varied terminology. This study identifies key clinical and radiological signs, including extracerebral fluid collection and enlarged subarachnoid spaces, aiding in accurate diagnosis and conservative management.

Area of Science:

  • Pediatric Neurology
  • Neuroradiology
  • Neurosurgery

Background:

  • External hydrocephalus is often confused with other subdural fluid collections, leading to diagnostic ambiguity.
  • Varied terminology such as subdural effusion, hygroma, and benign infantile hydrocephalus complicates literature interpretation.

Purpose of the Study:

  • To define clear clinical and radiological criteria for diagnosing external hydrocephalus.
  • To differentiate external hydrocephalus from other subdural fluid collections.

Main Methods:

  • Prospective study of five children (9 months to 2 years) with subdural fluid collection over 8 years.
  • Utilized established radiological and clinical criteria for suspected cases.

Main Results:

  • Four children presented with craniomegaly; one had a tense, bulging fontanelle.
  • CT scans revealed hemispheric extracerebral fluid collection and enlarged subarachnoid spaces in all cases.
  • Three children showed mild-to-moderate ventriculomegaly; two had borderline ventricular enlargement. All improved with conservative management.

Conclusions:

  • External hydrocephalus requires differentiation from other subdural fluid collections.
  • Key radiological criteria include extracerebral fluid collection, dilated subarachnoid spaces, and mild ventriculomegaly without significant periventricular lucency.
  • Conservative management, including acetazolamide, was effective in ameliorating clinical features.
Abstract

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