Related Experiment Videos
Acquired hydrocephalus associated with superior vena cava syndrome in infants
J F McLaughlin1, J D Loeser, T S Roberts
1Department of Pediatrics, University of Washington, Seattle, USA.
Insights
Superior vena cava syndrome in infants may lead to communicating hydrocephalus. This rare complication, observed in children undergoing cardiac or extracorporeal membrane oxygenation, may necessitate cerebrospinal fluid shunting.
Area of Science:
- Pediatric Cardiology
- Pediatric Neurology
- Neonatal Intensive Care
Background:
- Superior vena cava syndrome (SVCS) is a rare condition in infants.
- Communicating hydrocephalus is a buildup of cerebrospinal fluid (CSF) in the brain.
- The link between SVCS and communicating hydrocephalus is not well-established.
Observation:
- Retrospective review identified three infants with SVCS and subsequent communicating hydrocephalus.
- Two infants had SVCS secondary to extracorporeal membrane oxygenation for congenital diaphragmatic hernia with sepsis.
- One infant developed SVCS after cardiac surgery for transposition of the great vessels, leading to thrombosis and hydrocephalus.
Findings:
- The study suggests a potential causal link between superior vena cava syndrome and communicating hydrocephalus in infants.
- SVCS may impede CSF circulation or absorption, leading to hydrocephalus.
- This association appears to be an unusual complication of cardiac and great vein interventions.
Implications:
- Clinicians should consider SVCS as a potential cause of communicating hydrocephalus in at-risk infants.
- Early recognition and management of SVCS may prevent or mitigate hydrocephalus development.
- Further research is needed to elucidate the exact pathophysiology and guide treatment strategies, potentially including cerebrospinal fluid shunting.
Abstract:
We report observations on children with the unusual combination of superior vena cava syndrome in infancy followed by communicating hydrocephalus. Following retrospective review of hospital discharges at a tertiary children's hospital, three children were identified in a 13-year period. Two term infants were treated with extracorporeal membrane oxygenation for pulmonary failure associated with congenital diaphragmatic hernia. These infants had septic complications of central venous lines. A post-term infant required reconstruction of the superior vena cava following cannulation for cardiac bypass surgery to repair transposition of the great vessels. Thrombosis occurred and was followed by the sequential development of superior vena cava syndrome and communicating hydrocephalus. The findings in these patients suggest that communicating hydrocephalus may be caused by superior vena cava syndrome. This is an unusual complication of therapeutic manipulation of the heart and great veins. Cerebrospinal fluid shunting may be required.