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Suboccipito-vault skull diameter: an early indicator of ventricular dilatation in preterm babies
Insights
Suboccipito-vault height is a sensitive early indicator for progressive dilatation of the cerebral ventricles in preterm infants. This measurement may be valuable in centers lacking advanced ultrasound equipment.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Medical Imaging
Background:
- Dilatation of cerebral ventricles is a common complication in preterm infants.
- Early detection of ventricular dilatation is crucial for timely intervention.
- Standard head circumference measurements may not always reflect early ventricular changes.
Purpose of the Study:
- To evaluate suboccipito-vault height as an early indicator of cerebral ventricular dilatation.
- To compare the sensitivity of suboccipito-vault height with occipitofrontal head circumference in detecting ventricular dilatation.
Main Methods:
- Weekly measurement of suboccipito-vault height in 56 preterm infants (<1850g birthweight) for nine weeks.
- Correlation of suboccipito-vault height changes with ultrasonography findings of cerebral ventricles.
- Comparison with occipitofrontal head circumference measurements.
Main Results:
- Seven infants with ventricular dilatation showed suboccipito-vault height above the 97th centile within five weeks.
- Occipitofrontal head circumference did not exceed the 75th centile in these infants during the same period.
- In one infant undergoing cerebrospinal fluid removal, suboccipito-vault height did not increase.
Conclusions:
- Suboccipito-vault height is a sensitive early indicator of progressive cerebral ventricular dilatation.
- This measurement can be a valuable tool in neonatal units without immediate access to ultrasound facilities.
- Suboccipito-vault height offers a practical alternative for monitoring ventricular status in preterm neonates.
Abstract:
The distance between the inferior surface of the occiput and the superior surface of the vault of the skull was measured weekly during the first nine weeks of life in 56 preterm but appropriately grown babies with birthweights less than 1850g. For seven babies with dilatation of the cerebral ventricles (shown by ultrasonography) the suboccipito-vault height increased above the 97th centile within the first five weeks of life, although over the same period the occipitofrontal head circumference did not exceed the 75th centile. In the only other baby with ventricular dilatation the suboccipito-vault height did not increase while therapy with frequent removal of lumbar cerebrospinal fluid was performed. Suboccipito-vault height is a sensitive early indicator of progressive dilatation of the cerebral ventricles, and may be of value in centres without ultrasound facilities.