Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgements
- Glossary and abbreviations
- Section I Physics, safety, and patient handling
- Section II Normal appearances
- Section III Solving clinical problems and interpretation of test results
- 7 The baby with a suspected seizure
- 8 The baby who was depressed at birth
- 9 The baby who had an ultrasound as part of a preterm screening protocol
- 10 Common maternal and neonatal conditions that may lead to neonatal brain imaging abnormalities
- 11 The baby with an enlarging head or ventriculomegaly
- 12 The baby with an abnormal antenatal scan: congenital malformations
- 13 The baby with a suspected infection
- 14 Postmortem imaging
- Index
- References
11 - The baby with an enlarging head or ventriculomegaly
from Section III - Solving clinical problems and interpretation of test results
Published online by Cambridge University Press: 07 December 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgements
- Glossary and abbreviations
- Section I Physics, safety, and patient handling
- Section II Normal appearances
- Section III Solving clinical problems and interpretation of test results
- 7 The baby with a suspected seizure
- 8 The baby who was depressed at birth
- 9 The baby who had an ultrasound as part of a preterm screening protocol
- 10 Common maternal and neonatal conditions that may lead to neonatal brain imaging abnormalities
- 11 The baby with an enlarging head or ventriculomegaly
- 12 The baby with an abnormal antenatal scan: congenital malformations
- 13 The baby with a suspected infection
- 14 Postmortem imaging
- Index
- References
Summary
Introduction to the clinical problem
The widespread use of ultrasound imaging has completely changed the nature of neonatal practice in many areas, not least with regard to the diagnosis and management of hydrocephalus. It is very rare nowadays to be presented with a baby with a rapidly enlarging head circumference, dilated scalp veins and sunsetting eyes, because most cases are detected antenatally or detected in postnatal life before clinical signs develop. The widespread availability of ultrasound imaging means that it is no longer necessary to make the diagnosis by transillumination of the skull or air encephalography. The detection of ventriculomegaly in an asymptomatic fetus or neonate has created new challenges, because at the time of initial diagnosis it cannot be known whether progressive ventricular dilatation will develop.
The availability of imaging does not mean that postnatal measurement of the head circumference is redundant, and serial measurements are still vitally important in helping to determine whether the ventricles are enlarging progressively. Babies still present with large heads which are due to familial megalencephaly, and it is essential to measure the head circumference of both parents in a well baby with a big head before embarking on an expensive series of investigations which may not be necessary, and will only serve to worry the parents.
Ventriculomegaly may be congenital or acquired. In this chapter we discuss fetal ventriculomegaly, postnatally acquired ventricular dilatation, and the management and prognosis of non-progressive and progressive ventriculomegaly.
- Type
- Chapter
- Information
- Neonatal Cerebral Investigation , pp. 235 - 247Publisher: Cambridge University PressPrint publication year: 2008