Large Congenital Hydrocephalus:Extended Survival without Neurosurgery

Area of Science:

• Neurology
• Developmental Pediatrics
• Case Study

Background:

• A 45-year-old male patient presented with severe congenital hydrocephalus.
• Born prematurely at 26 weeks gestation, the patient's head circumference measurements showed rapid progression from birth (27.9 cm) to 18 months (74 cm).
• Due to the severe and rapidly progressing hydrocephalus, a terminal prognosis was given during infancy, and no neurosurgical intervention was pursued.

Purpose of the Study:

• To report on the long-term survival and clinical status of a patient with severe congenital hydrocephalus.
• To document the extreme head circumference measurements and associated cranial deformities in this unique case.
• To highlight the role of diligent professional care in managing complex developmental conditions.

Main Methods:

• Case report detailing the clinical history and physical examination findings of a patient with congenital hydrocephalus.
• Longitudinal tracking of head circumference measurements from birth to adulthood.
• Observation of clinical stability and management at a developmental center.

Main Results:

• The patient survived to 45 years of age with severe congenital hydrocephalus, exceeding the initial terminal prognosis.
• Current head circumference is 88.4 cm (adult normal: 52-58 cm).
• The patient developed deformational plagiocephaly and scaphocephaly due to habitual unilateral decubitus, with current occipitofrontal circumference 36.8 cm and biparietal width 12.5 cm.

Conclusions:

• Extended survival in severe congenital hydrocephalus is possible with dedicated professional care.
• This case underscores the importance of multidisciplinary management for patients with complex congenital conditions.
• Long-term clinical stability can be achieved even with significant untreated hydrocephalus and resulting cranial deformities.