Presentation
Congenital hydrocephaly - assessment before decision on shunting.
Patient Data
Age: 5 months
Gender: Male
From the case:
Hydranencephaly
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Hydranencephaly: monoventricle surrounded by rind of cerebrum; importantly, lack of fused anterior cerebral mantle and presence of falx cerebri (anteroinferior part) rule out alobar holoprosencephaly.
Case Discussion
Infant with congenital macrocephaly due to hydranencephaly with active hydrocephalus.
Conservative approach exhausted, hydrocephalus still active despite treatment with acetazolamide. A decision was reached with the parents that at first, an externalized ventricular shunt shall be placed, then, after excess CSF has been drained out and intracranial pressure normalises, the distal shunt will be internalized into the peritoneum.