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Hydrocephalus pp 337-352 | Cite as

Surgical Management of Hydrocephalus Accompanying Cystic Lesions in Infancy

  • Tetsuhiko Asakura
  • Masaki Niiro
  • Fumiaki Yuhi
  • Kanetaka Kimotsuki

Summary

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.

Keywords

Hydrocephalus Cystic tumors In infancy Cyst drainage Cranial echography 

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Copyright information

© Springer-Verlag Tokyo 1991

Authors and Affiliations

  • Tetsuhiko Asakura
  • Masaki Niiro
  • Fumiaki Yuhi
  • Kanetaka Kimotsuki
    • 1
  1. 1.Department of Neurosurgery, Faculty of MedicineUniversity of KagoshimaKagoshima, 890Japan

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