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[Ventricular subarachnoidal hydrocephalus of arachnoid villi origin]
1Clinique Neurochirurgicale, CHRU Clermont-Ferrand, Hôpital Fontmaure, Chamalières.
Insights
In infants, increased intracranial cerebrospinal fluid (CSF) volume was common, correlating with ventricular and pericerebral spaces. This suggests a delay in CSF reabsorption due to immature arachnoid villi.
Area of Science:
- Neurology
- Pediatrics
- Neuroimaging
Background:
- Infants can present with various neurological symptoms requiring investigation.
- Cerebrospinal fluid (CSF) dynamics are crucial for maintaining intracranial pressure and brain health.
Purpose of the Study:
- To analyze CT scan findings in infants with neurological symptoms.
- To investigate the causes of increased intracranial CSF volume in infants.
Main Methods:
- Systematic review of CT scans in 102 infants (0.5-22 months) focusing on ventricular size, pericerebral space, and interhemispheric fissure.
- In-depth investigation of two cases with severe axial hypotonia using intracranial pressure monitoring, infusion tests, isotopic cisternography, and angiography.
Main Results:
- 70% of infants showed increased intracranial CSF volume, with good correlation between ventricular and pericerebral volumes.
- Investigations in severe hypotonia cases ruled out venous anomalies and CSF obstruction, pointing towards impaired CSF reabsorption.
Conclusions:
- Idiopathic disturbance of CSF reabsorption is a likely cause of increased intracranial CSF volume in infants.
- A delay in the maturation of arachnoid villi, typically resolving by 18 months, may explain this condition in infants.
Abstract:
In 102 infants (0.5 to 22 months), the C.T. scan performed for various neurological symptoms, was systematically reviewed with analysis of ventricular size, pericerebral space and interhemispheric fissure. In 70% of the cases, an increase of the intracranial volume of C.S.F. was noted, with a good correlation between the ventricular and pericerebral volume. The authors discuss the pathophysiological mechanism of this condition an evoke the possibility of an idiopathic disturbance of the C.S.F. reabsorption. In two cases, suffering from severe axial hypotonus, this fact was explored by four methods: continuous monitoring of intracranial pressure, intraventricular infusion test, isotopic cisternography through ventricular injection and venous phase of angiography. From these investigations showing no venous anomaly, and because of the lack of any pathological event able to induce a C.S.F. obstruction, we suggest a delay in the maturation of arachnoïd villi (normally ended at 18 months) to explain this condition.