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[Transient obstructive hydrocephalus of an infant following mild head injury (author's transl)]
Insights
Transient obstructive hydrocephalus can cause vomiting in children after head injury. CT scans revealed temporary blockage of the aqueduct, leading to acute hydrocephalus and subsequent resolution of symptoms.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Trauma Surgery
Background:
- Vomiting and somnolence are common symptoms following head injury in children.
- Differentiating between symptoms due to intracranial mass lesions and other causes is crucial for appropriate management.
Observation:
- A 1.5-year-old boy presented with vomiting and somnolence four days post-head injury.
- Initial CT scans showed high-density areas in the prepontine and ambient cisterns and aqueduct, with dilated lateral and third ventricles.
Findings:
- The patient's symptoms resolved within one day.
- Follow-up CT scans revealed complete resolution of the high-density areas and ventricular dilatation.
- The vomiting was attributed to transient obstructive hydrocephalus caused by a small clot in the aqueduct.
Implications:
- Transient obstructive hydrocephalus should be considered in the differential diagnosis of post-traumatic vomiting in children.
- CT imaging is valuable for evaluating vomiting in pediatric head injury cases, even in the absence of mass lesions.
- This case highlights the importance of recognizing temporary cerebrospinal fluid pathway obstruction after trauma.
Abstract:
One and a half years old boy was admitted with vomiting and somnolence four days after head injury. The first CT scans taken on admission showed high density areas in the prepontine and ambient cisterns and in the aqueduct. The lateral and third ventricles were dilated, while the fourth ventricle was normal. On the 2nd hospital day he was nearly asymptomatic. The second CT scans done seven days after injury no longer revealed the high density areas and the ventricular dilatation. Vomiting is one of the most important signs for intracranial mass lesions after head injury. But children often vomit even without having mass lesions, and CT scan is useful for evaluation of such cases. In our case, vomiting was probably due to aqueductal obstruction by a small clot resulting acute hydrocephalus, as revealed by CT scans. This case suggested that transient obstructive hydrocephalus must be taken into consideration as one of causes for posttraumatic vomiting.