Surgical Management of Hydrocephalus Accompanying Cystic Lesions in Infancy
We report four cases of acute hydrocephalus caused by cystic lesions in infancy and discuss the therapeutical problems involved in the management of this type of hydrocephalus. The mass lesions were an astrocytoma, a choroid plexus papilloma, an angioma, and an arachnoid cyst. Cystic tumors in infancy are always large by the time they are diagnosed, so that intracranial pressure (ICP) is always high and general condition is sometimes poor. It is preferable that ICP is reduced gradually when preparing for operation. Therefore, a stepwise procedure is recommended, that is, a draining procedure prior to the radical operation. In a baby with a fairly enlarged head, rapid reduction of ICP is danger, along with massive bleeding. Conditions are more favorable for us if we have enough time to carry out further examinations, such as cerebral angiography, MRI, and more detailed evaluations of the patient’s general condition. Cyst drainage is effective for managing hydrocephalus in cystic tumors. If the production of fluid in the cyst is not great, a repeated tap through the reservoir is always sufficient for managing the increased ICP. Also, echography, in addition to conventional computed tomography (CT) scanning and magnetic resonance imaging (MRI), is useful in observing the size of the cyst or the ventricle.
KeywordsHydrocephalus Cystic tumors In infancy Cyst drainage Cranial echography
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- Han BK, Babcock DS, Oestreich AE (1984) Sonography of brain tumors in infants. AJNR 5: 253–258Google Scholar
- Hayashi R, Hashimoto T, Fukusumi A (1983) A case of teratoma in newborn. Nerv Syst Child 8: 17–24Google Scholar
- Hayashi T, Honda E, Anegawa S, Kuramoto S (1987) Clinical evaluation of children with intracranial arachnoid cysts treated surgically. Nerv Syst Child12: 185–192Google Scholar
- Iwasaki Y, Wakai S, Matsutani M, Takakura K, Sano K (1980) Brain tumors in infants. Nerv Syst Child 5: 391–398Google Scholar
- Karube T, Yano S, Miyao M, Kamoshita S, Iwasa H, Shimabukuro H, Yamada N, Murase I (1985) Three cases of arachnoid cyst of the quadrigeminal cistern. Nerv Syst Child 10: 347–352Google Scholar
- Kawano H, Hayashi M, Kubota T, Ishikura A, Kobayashi H, Tsuji T (1986) Infantile choroid plexus papilloma. Nerv Syst Child 11: 193–198Google Scholar
- Kikuchi K, Kamisato N, Kowada M, Mineura K (1985) Large cystic oligodendroglioma in childhood. Nerv Syst Child 10: 329–334Google Scholar
- The committee of the Brain Tumor Registry in Japan (1982) Brain tumors in children. pp 26-30Google Scholar
- Uematsu Y, Kuwata T, Iwamoto M, Kuriyama T, Shizuki K (1986) Choroid plexus papilloma of the lateral ventricle with relapsing intraventricular hemorrhage in an infant. Nerv Syst Child 11: 415–420Google Scholar