Caffey award: cranial sonographic findings in meningomyelocele

Children with meningomyeloceles have problems involving several organ systems and often require repeated radiologic examinations. They have multiple cranial defects, particularly the Arnold-Chiari II malformation and associated hydrocephalus. Cranial sonographic findings in 29 patients included hydrocephalus with pointing of the frontal horns, asymmetry of the lateral ventricles, and relative enlargement of the occipital horns compared with the frontal horns. Partial absence of the septum pellucidum, abnormalities of the third ventricle including a prominent massa intermedia, prominent anterior commissure, and prominent suprapineal recess were also seen. A V-shaped tentorium cerebelli was demonstrated on axial scan as well as low position of the tent on coronal scan. The posterior fossa pseudomass was demonstrated. A prominent interhemispheric fissure was also seen in some patients. Sonography is an excellent method for following ventricular size and shunt function since repeated examinations can readily be performed.