Abstract
The authors reviewed 47 cases of infantile subdural fluid collection with regard to diagnosis and postoperative course after placement of a subdural-peritoneal shunt. CT scan with contrast enhancement proved to be an important diagnostic modality, showing vessels in the subarachnoid space as high-density spots. Utilizing this technique, we were able to differentiate the following varieties of fluid collection: (1) subdural fluid collection, in which enhancing vessels were seen on the brain surfae, (2) subarachnoid fluid collection, in which vessels were on the inner table of the cranium, and (3) coexistence of subdural and subarachnoid fluid collections, in which vessels were between the inner table of the cranium and the brain surface. The postoperative course of subdural fluid collection was characterized as follows: (1) the subdural fluid collection decreased first, with increased subarachnoid fluid collection; (2) the subarachnoid fluid collection remained after the disappearance of subdural fluid collection; and (3) the brain expanded again later. Subdural fluid collection disappeared about 1 month after the shunt operation, which could lead occlusion of the shunt system. Postoperative enlargement of the subarachnoid space was an early indicator of the efficacy of the subduralperitoneal shunt.
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References
Aoki N (1990) Chronic subdural hematoma in infancy. Clinical analysis of 30 cases in the CT era. J Neurosurg 73:201–205
Anderson H, Elfverson J, Svendsen P (1984) External hydrocephalus in infants. Child's Brain 11:398–402
Barlow C (1984) CSF dynamics in hydrocephalus — with special attention to external hydrocephalus. Brain Dev 6:119–127
Bosjak V, Besenski N, Marusic-Della Marina B Kogler A (1989) Cranial ultrasonography in the evaluation of macrocrania in infancy. Dev Med Child Neurol 31:66–75
Carolan PL, McLaurin RL, Towbin RB, Towbin JA, Egellhoff JC (1985–86) Benign extra-axial collections of infancy. Pediatr Neurosci 12:140–144
Chapman PH (1983) External hydrocephalus. Concepts Pediatr Neurosurg 4:102–118
Fukushima T, Takagi T, Nagai H, Banno T (1988) MRI of subdural fluid collections in infants (in Japanese). Shoni No Noshinkei 13:381–387
Kendall B, Holland I (1981) Benign communicating hydrocephalus in children. Neuroradiology 21:93–96
Kleinman PK, Zito JL, Davidson RI, Raptopoulos V (1983) The subarachnoid spaces in children: normal variations in size. Radiology 147:455–457
Masuzawa H, Aoki N, Sato J (1982) Subdural effusion (hematoma) accompanied by enlargement of subarachnoid spaces (in Japanese). Neurol Med Chir (Tokyo) 22:751–756
Maytal J, Alvarez LA, Elkin CM, Shinnar S (1987) External hydrocephalus: radiologic spectrum and differentiation from cerebral atrophy. AJNR 8:271–278
McComb JG (1989) Cerebrospinal fluid formation and absorption. In: McLaurin RL, Venes JL, Schut L, Epstein F (eds) Pediatric neurosurgery. Saunders, Philadelphia, pp 159–179
McLaurin RL (1985) Subdural hematomas and effusions in children. In: Willkins RH, Rengachary SS (eds) Neurosurgery: developmental anomalies and neurosurgical diseases of childhood. McGraw-Hill, New York, pp 2211–2215
McLaurin RL, McLennan JE (1982) Diagnosis and treatment of head injury in children. In: Youmans JR (ed) Neurological surgery. Saunders, Philadelphia, pp 2084–2136
McLaurin RL, Towbin R (1989) Posttraumatic hematomas. In: McLaurin RL, Venes JL, Schut L, Epstein F (eds) Pediatric neurosurgery. Saunders, Philadelphia, pp 277–289
McLaurin RL, Isaacs E, Lewis HP (1971) Results of nonoperative treatment in 15 cases of infantile subdural hematoma. J Neurosurg 34:753–759
Ment LR, Duncan CC, Geehr R (1981) Benign enlargement of the subarachnoid spaces in the infant. J Neurosurg 54:504–508
Modic MT, Kaufman B, Bonstelle CT, Tomsick TA, Weinstein MA (1981) Megalocephaly and hypodense extracerebral fluid collections. Radiology 141:93–100
Mori K, Handa H (1977) Subdural haematoma (effusion) and internal hydrocephalus. Neurochirurgia 20:154–161
Morota N, Sakamoto K (1988) Infantile expanding subarachnoid fluid collection and CT findings (in Japanese). CT Kenkyu 10:153–160
Raimondi AJ, Cerullo EM (1980) Pediatric cerebral angiography In: Nadimi M (ed) Neuroradiological atlantes. Thieme, New York, pp 30–36
Robertson WC, Gomez MR (1978) External hydrocephalus, early findings in congenital communicating hydrocephalus. Arch Neurol 35:541–544
Robertson WC, Chun RWM, Orrison WW, Sackett JF (1979) Benign subdural collections of infancy. J Pediatr 94:382–385
Snow RB, Zimmerman RD, Gandy SD, Deck MDF (1986) Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury. Neurosurgery 18:45–52
Tsubokawa T (1977) Differential diagnosis between subdural and subarachnoidal effusion (in Japanese). Shoni no Noshinkei 2:29–39
Tsubokawa T, Nakamura S, Satoh K (1984) Effect of temporary subdural-peritoneal shunt on subdural effusion with subarachnoid effusion. Child's Brain 11:47–59
Wilms G, Vanderschueren G, Demaerel PM, Smet MH, Van Calenbergh F, Piets C, Goffin J, Casaer P (1993) CT and MR in infants with pericerebral collection and macrocephaly: benign enlargement of the subarachnoid spaces versus subdural collections. AJNR 14:855–860
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Morota, N., Sakamoto, K., Kobayashi, N. et al. Infantile subdural fluid collection: diagnosis and postoperative course. Child's Nerv Syst 11, 459–466 (1995). https://doi.org/10.1007/BF00334966
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DOI: https://doi.org/10.1007/BF00334966