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This study reviewed CT scans of 500 children, identifying a benign form of communicating hydrocephalus in 8% of cases. Many children showed improvement or stable conditions, with scan abnormalities often regressing over time.
Area of Science:
- Pediatric Radiology
- Neurology
- Neuroimaging
Background:
- Computed tomograms (CTs) in children can present findings suggestive of cerebral atrophy.
- Some cases with widened supratentorial subarachnoid spaces and normal brain parenchyma are misdiagnosed.
Purpose of the Study:
- To review CT findings in children with widened subarachnoid spaces and normal cerebral substance.
- To identify and characterize a specific subgroup of pediatric patients with enlarged heads and normal ventricles.
Main Methods:
- Retrospective review of 500 pediatric CT scans initially reported with widened subarachnoid spaces.
- Selection of 40 cases (8%) exhibiting large or enlarging heads with normal or minimally enlarged ventricles.
- Clinical and radiological follow-up over 2 years.
Main Results:
- The selected 40 children generally showed clinical improvement or stability.
- Radiological abnormalities regressed in 22.5% and remained static in 67.5% of cases.
- Only one case progressed to classical communicating hydrocephalus requiring a shunt.
Conclusions:
- The condition represents a generally benign and mild form of communicating hydrocephalus in children.
- An apparent etiological factor was identified in approximately two-thirds of the studied cases.
- This radiological finding often resolves or stabilizes without significant intervention.
Abstract:
A review was performed of the computed tomograms (CTs) of 500 children which had been reported as showing widening of the supratentorial subarachnoid spaces with normal cerebral substance. On the basis of this a radiological diagnosis of cerebral atrophy had been made in all but five, who were said to have megalencephaly. From these, the children with large or abnormally enlarging heads, but normal or only slightly enlarged ventricles, were selected; there were 40 such cases (8%). The clinical condition either improved or remained stable over a period of 2 years; in the majority the scan abnormality regressed (22.5%) or remained static (67.5%). In three cases there was slight progression of the CT changes before stabilisation, but only one case developed classical communicating hydrocephalus necessitating a shunt procedure. This condition is a generally benign and mild form of communicating hydrocephalus, for which an aetiological factor was apparent in about two-thirds of the cases studied.