[Ultrasonic diagnosis in hydrocephalus]

Sonographic evaluation of the brain offers a noninvasive, safe and inexpensive method in diagnosis and follow-up of hydrocephalus associated with meningomyelocele. Cranial computed tomography should be reserved for special questions such as assessment of bony structures, subdural effusions or if fontanelles and sutures are already closed. Ultrasound of the neonatal head is completely harmless, repeated examinations can easily be performed and sedation of the infant is usually not necessary. The method of ultrasound sections in different directions is demonstrated and compared to axial CT sections. Value, effectiveness and diagnostic interpretation of the method are demonstrated in four cases: 1. Small lumbar meningomyelocele with mild hydrocephalus without enlargement on follow-up. 2. Giant spinal defect with kyphoskoliosis, marked hydrocephalus and associated ventricle abnormalities. 3. Sonographic follow-up after ventriculo-atrial shunting in a patient with congenital hydrocephalus. 4. Cerebrospinal fluid abdominal pseudocyst after ventriculo-peritoneal shunting. Thus ultrasound is an excellent method for following ventricular size and shunt-function in meningomyelocele-patients.