Congenital unilateral hydrocephalus

Case contributed by Dr Abdallah Khateeb

Presentation

Prenatal diagnosis of ventriculomegaly. The baby was fine otherwise. MRI shortly after birth and at one year of age were obtained.

Patient Data

Age: newborn
Gender: Female
MRI

Brain MRI at 5 days old

There is marked dilatation of the right lateral ventricle which slightly herniates into the left side and causes effacement of sulci at the overlying brain parenchyma. The left lateral ventricle, third ventricle, and fourth ventricle are normal in size. 
There is no periventricular CSF seepage, indicating a chronic process.
Adjacent brain parenchyma appears normal.
There is no adjacent parenchymal Gliosis.

MRI

Follow up brain MRI at 1 year old

Apart from normal timely myelination, after time lapse of one year, the findings are almost unchanged. No obvious mass of focal abnormality near the foramen of Munro. 

Case Discussion

The vast majority of congenital hydrocephalus patients develop it as of a bilateral symmetrical process, while in the less common type of obstructive hydrocephalus, as in this case, only one-sided lateral ventricular dilatation is seen.

Knowing basic anatomy of the ventricular system, one can tell that the obstruction of CSF flow is expected to be at the level of the foramen of Monro, and may include a web, or an intraventricular cyst (not visualized). 

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Case information

rID: 43281
Case created: 3rd Mar 2016
Last edited: 16th Nov 2017
Inclusion in quiz mode: Included

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