Paediatric hydrocephalus: Pre-treatment computed tomography findings in 80 consecutive patients

Abstract

Background: Hydrocephalus, a common indication for paediatric neuro-imaging, results from any disorder in the formation, circulation and absorption of cerebrospinal fluid. Serious neurological sequelae often result if neglected. Computed Tomography (CT) plays a vital role in revealing the various aetiologies of hydrocephalus in order to guide intervention.
Objectives: To retrospectively assess the spectrum of CT findings in children with clinical features of hydrocephalus referred to the CT suite of a tertiary hospital in South-East Nigeria for radiodiagnosis and compare with findings in existing literature
Materials and Methods: We evaluated 80children- 32 females and 48 males- over a period of one year. Included also in this study were children with clinical features of hydrocephalus who presented with other findings such as delayed developmental milestones and congenital neural tube defects.
Results:The age range was 0.01 to 14 years, a mean of 2.23 years. 56.3% of the cases had CT features consistent with obstructive hydrocephalus- ventriculomegaly proximal to the site of obstruction with normal-sized
ventricles distal to the obstruction). The communicating subtype, hydranencephaly and Benign External Hydrocephalus were seen in 36.25%, 6.2% and 1.25% respectively. The level of predilection for ventricular
obstruction was the Aqueduct of Sylvius in 75.6%. Secondary causes were demonstrable in 10 of the children with aqueductal stenosis (AS) while 24 had no evident secondary cause. Congenital AS occurred more in males-
17, as against 7 females; however, there was no significant correlation between gender and predisposition for AS (P= 0.546).
Conclusion: This study demonstrates the positive yield of computed tomography in the diagnosis of hydrocephalus in children albeit the downside of exposure to ionizing radiation.