Diagnosis and Postoperative Follow-up Studies of Infantile Hydrocephalus Using Computerized Tomography

Abstract

Diagnosis of infantile hydrocephalus was up to now only possible by pneumencephalography and echoencephalography. Measurements of the normal ventricle size are criteria in order to define pathologic alterations. Pneumencephalography has the disadvantage in that it involves considerable risk to the patient. Echoencephalography has the disadvantage that it only offers a static one-dimensional display. The two dimensional echonencephalograms, due to technical reasons, are of little value. Computerized tomography permits the evaluation of ventricle size and the diagnosis of hydrocephalus. The CSF, due to its low density, is well demarcated from normal brain matter (Fig. 1). The depth of the examined sections has to be modified according to the size of the head. Very large heads with a fronto-occipital diameter of more than 23 cm could not be examined since the head box was too small. In children under 4 years the examination was usually carried out under anesthesia. We have examined 260 children with hydrocephalus, 100 selected normal cases, and 125 patients after shunt operation. In the case of a hydrocephalusocclusus CT permits its cause to be detected by the direct visualization of a tumor. An exact analysis of the dilatation pattern permits the position of the CSF block to be found. In 16 cases out of 260 hydrocephali there was a nontumorous stenosis of the aqueduct or the foramina of the posterior fossa (see Figs. 2 and 3).