htdrocepchalus in chiidren diagnostic imging and radiological characeristics

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1、JeffEdwardsGillianLieberman,MDJanuary2002HydrocephalusinChildren:HydrocephalusinChildren:DiagnosticImagingandDiagnosticImagingandRadiologicalCharacteristicsRadiologicalCharacteristicsJeffEdwards,HarvardMedicalSchool,YearIIIGillianLieberman,MDJeffEdwardsGillianLieberman,MDAg

2、endaAgendaIntroductiontothePatientMacrocephalyBasicsofHydrocephalusDiagnosticImagingofHydrocelphalus–Ultrasound,CT,MRShunts2JeffEdwardsGillianLieberman,MDThePatientThePatient6yoboywithmacrocephaly,whichmanifestedinthefirstyearoflifeasexcessiveheadgrowth,accompaniedbyr

3、educedactivityandpoorfeeding.Othersignificantmedicalhxincludescognitivedelay,osteogenesisimperfectatype2,restrictivelungdisease.Birthhx:bornat34½wkprematurebyc-sectionwithsubsequent25dayNICUcoursesignificantforapneicandbradycardicspellsUsedwithpermissionofNofamilyhxoflar

4、geheadspatient’smother3JeffEdwardsGillianLieberman,MDMacrocephalyMacrocephalyinInfantorChildinInfantorChildDefinedasaheadcircumferencemorethan2SDabovethemeanforageandsexExcessiverateofheadgrowthovertimesuggestsincreasedintracranialpressure–Mostoftencausedbyhydrocephalus,e

5、xtra-axialfluidcollections,orneoplasmsMacrocephalywithnormalheadgrowthratesuggestsfamilialmacrocephalyortruemegalencephaly4JeffEdwardsGillianLieberman,MDDDxDDxofofMacrocephalyMacrocephalyCausesExamplesPseudomacrocephaly,Growingprematureinfant,recoverypseudohydrocephalus,ca

6、tch-upgrowthfrommalnutrition,congenitalheartdiseaseIncreasedintracranialpressureProgressivehydrocephalus,subduralwithdilatedventricleseffusion,hydrancephalywithothermassArachnoidcyst,porencephaliccyst,braintumorBenignfamilialmacrocephalyBenignenlargementofsubarachnoidspaces

7、,congenitalcommunicating(idiopathicexternalhydrocephalus)hydrocephalus,benignsubduralcollectionsofinfancy5JeffEdwardsGillianLieberman,MDDDxDDxofofMacrocephalyMacrocephaly(cont(cont’’d)d)MegalencephalyBenignfamilial(seeabove)withneurocutaneousdisorderNeurofibromatosis,tubero

8、ussclerosiswithgigantismSotosyndromewithdwarfismAchondroplasiametabolicMucopolysac