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To Study the Neurosonographic Pattern of Hydrocephalus Among the Under Five Children in Our Institute

Madhura Panditrao , Madhura Panditrao1 , Suhas Ghule2 , Sunil Natha Mhaske3

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Pediatric Education and Research 7(3):p 97-101, July-September 2019. | DOI: DOI: https://dx.doi.org/10.21088/per.2321.1644.7319.3

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Madhura Panditrao, Suhas Ghule, Sunil Natha Mhaske. To Study the Neurosonographic Pattern of Hydrocephalus Among the Under Five Children in Our Institute. Pediatr Edu Res. 2019;7(3):97–101.

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Abstract

Background: Hydrocephalus is a common condition in Paediatric Neurosurgery. In hydrocephalus there is dilatation of the ventricular system further causing compressive effects on the parenchyma. Hydrocephalus is a common and important process, a mechanical complication of many different pathologic conditions and a disease process itself. The morphologic features are easily recognizable, but the pathophysiology remains incompletely understood. It can be in communicative/non-obstructive or non-communicative/ obstructive forms. Neurosonogram and CT/MRI brain are the main investigations. Ventriculoperitoneal shunt remains the gold standard of treatment. Objective: To assess the neurosonographic features of children under 5 years of age with clinical signs of raised intracranial pressure suggestive of hydrocephalus. Therefore, it results in early detection and proper management. Patients and Methods: This is a retrospective study of neurosonographic findings in 70 children with signs of raised intracranial pressure suggestive of Hydrocephalus (42 boys and 28 girls) admitted in our department. The mean age of cases was 5.0 ± 4.2 months. Neurosonogram was done when there were clinical indications like congenital hydrocephalus, encephalocele, meningomyelocele, and meningitis. All scans were performed through the anterior fontanelle with a curvilinear probe using frequency transducer of 2–4 MHz. Results: Of the study group 57 cases had congenital hydrocephalus (81.3%). Postmeningitic hydrocephalus was seen in 12 cases (17.2%) while only 1 case (1.6%) was due to post-hemorrhagic cause. Of the 57 congenital cases 27 patients (47.3%), had cerebral aqueduct stenosis as their cause. 12 (21.2%) of the congenital cases were due to obstruction at the exit foramina of Luschka and Magendie causing the communicating type of hydrocephalus. Conclusion: Hydrocephalus is a common cause of neurological morbidity among infants in developing countries. Most cases have congenital origin and are most commonly due to cerebral aqueduct stenosis. Neurosonogram through the anterior fontanell is cheap, affordable, and more accessible than other imaging modalities. It should serve as the first line investigation of infants with suspected hydrocephalus for early detection and monitoring of progression to determine those cases that would require shunt operation, thereby reducing infant morbidity.

Keywords: Hydrocephalus; Pattern; Sonographic; Under five children; Management; Shunt.

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Cite this article

Madhura Panditrao, Suhas Ghule, Sunil Natha Mhaske. To Study the Neurosonographic Pattern of Hydrocephalus Among the Under Five Children in Our Institute. Pediatr Edu Res. 2019;7(3):97–101.

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DOI: DOI: https://dx.doi.org/10.21088/per.2321.1644.7319.3

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