Paediatric hydrocephalus - size does matter!

Abstract

Hydrocephalus refers to a pathological condition that occurs when there is an excessive accumulation of cerebrospinal fluid (CSF) in the head. Hydrocephalus can either be congenital, resulting from disturbance in the development of the CSF pathways or alternatively, it is acquired due to secondary events resulting in blockage to circulation channels. Hydrocephalus can be further categorised into obstructive and non-obstructive subcategories. It is known that hydrocephalus occurs as a result of either an obstruction to the flow of CSF and/or the body's inability to absorb it. This ultimately increases the pressures within the brain due to the swelling caused by the build-up of CSF within the ventricles and subarachnoid spaces. In Australia, one in a thousand children are born with hydrocephalus per year. This figure is excluding acquired hydrocephalus in older children and adults. In infants, hydrocephalus is often associated with an increase in head circumference. They may also present with lethargy, vomiting, poor feeding, seizures, nystagmus and low muscle tone. Without proper diagnosis for early intervention and management, hydrocephalus may result in compromised mental functioning, visual disturbances, walking difficulty, incontinence and reduced conscious state. Cranial ultrasound has emerged as an effective imaging modality in diagnosing progressive ventricle dilation in the infant population and may be used for continuous follow-up. This talk will cover the role of ultrasound and its major benefits in the diagnosis and detection of hydrocephalus for the paediatric population.