Benign enlargement of subarachnoid spaces in infancy (BESS)

Case contributed by Safwat Mohammad Almoghazy
Diagnosis almost certain

Presentation

Presented to our causality with a history of head trauma.

Patient Data

Age: Infant <1 year
Gender: Male

There are prominent subarachnoid spaces were noted in bilateral frontal and temporal lobes (more on the frontal lobes) with prominent Sylvian fissures. Widening of the interhemispheric sulcus and bridging veins along with CSF spaces were noted in the bilateral frontal regions. There was no displacement of the veins away from the calvarium. 

Bilateral lateral ventricles appeared slightly prominent with no periventricular hypodensity. The brain parenchyma shows no obvious abnormal attenuation values. 

Conclusion:

The findings are suggestive of benign enlargement of the subarachnoid space in infancy (BESS ) and no need for further urgent imaging management.

Case Discussion

An incidentally discovered benign enlargement of the subarachnoid space in infancy (BESS). It's a benign self-limited condition, most were seen in infants. It is characterized by macrocephaly and enlargement of subarachnoid space with normal or mildly dilated ventricles. 

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