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11 - The baby with an enlarging head or ventriculomegaly

from Section III - Solving clinical problems and interpretation of test results

Published online by Cambridge University Press:  07 December 2009

By
Cornelia F. Hagmann ,
Janet M. Rennie  and
Nicola J. Robertson
Edited by
Janet M. Rennie ,
Cornelia F. Hagmann  and
Nicola J. Robertson
Cornelia F. Hagmann
Affiliation:
Clinical Lecturer and Honorary Consultant Neonatologist, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals
Janet M. Rennie
Affiliation:
Consultant and Senior Lecturer in Neonatal Medicine, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals
Nicola J. Robertson
Affiliation:
Senior Lecturer in Neonatology and Honorary Consultant Neonatologist, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals
Janet M. Rennie
Affiliation:
University College London
Cornelia F. Hagmann
Affiliation:
University College London
Nicola J. Robertson
Affiliation:
University College London
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Summary

Introduction to the clinical problem

The widespread use of ultrasound imaging has completely changed the nature of neonatal practice in many areas, not least with regard to the diagnosis and management of hydrocephalus. It is very rare nowadays to be presented with a baby with a rapidly enlarging head circumference, dilated scalp veins and sunsetting eyes, because most cases are detected antenatally or detected in postnatal life before clinical signs develop. The widespread availability of ultrasound imaging means that it is no longer necessary to make the diagnosis by transillumination of the skull or air encephalography. The detection of ventriculomegaly in an asymptomatic fetus or neonate has created new challenges, because at the time of initial diagnosis it cannot be known whether progressive ventricular dilatation will develop.

The availability of imaging does not mean that postnatal measurement of the head circumference is redundant, and serial measurements are still vitally important in helping to determine whether the ventricles are enlarging progressively. Babies still present with large heads which are due to familial megalencephaly, and it is essential to measure the head circumference of both parents in a well baby with a big head before embarking on an expensive series of investigations which may not be necessary, and will only serve to worry the parents.

Ventriculomegaly may be congenital or acquired. In this chapter we discuss fetal ventriculomegaly, postnatally acquired ventricular dilatation, and the management and prognosis of non-progressive and progressive ventriculomegaly.

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Neonatal Cerebral Investigation , pp. 235 - 247
Publisher: Cambridge University Press
Print publication year: 2008

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  • The baby with an enlarging head or ventriculomegaly
    • By Cornelia F. Hagmann, Clinical Lecturer and Honorary Consultant Neonatologist, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals, Janet M. Rennie, Consultant and Senior Lecturer in Neonatal Medicine, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals, Nicola J. Robertson, Senior Lecturer in Neonatology and Honorary Consultant Neonatologist, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals
  • Edited by Janet M. Rennie, University College London, Cornelia F. Hagmann, University College London, Nicola J. Robertson, University College London
  • Book: Neonatal Cerebral Investigation
  • Online publication: 07 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544750.013
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  • The baby with an enlarging head or ventriculomegaly
    • By Cornelia F. Hagmann, Clinical Lecturer and Honorary Consultant Neonatologist, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals, Janet M. Rennie, Consultant and Senior Lecturer in Neonatal Medicine, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals, Nicola J. Robertson, Senior Lecturer in Neonatology and Honorary Consultant Neonatologist, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals
  • Edited by Janet M. Rennie, University College London, Cornelia F. Hagmann, University College London, Nicola J. Robertson, University College London
  • Book: Neonatal Cerebral Investigation
  • Online publication: 07 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544750.013
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • The baby with an enlarging head or ventriculomegaly
    • By Cornelia F. Hagmann, Clinical Lecturer and Honorary Consultant Neonatologist, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals, Janet M. Rennie, Consultant and Senior Lecturer in Neonatal Medicine, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals, Nicola J. Robertson, Senior Lecturer in Neonatology and Honorary Consultant Neonatologist, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London Hospitals
  • Edited by Janet M. Rennie, University College London, Cornelia F. Hagmann, University College London, Nicola J. Robertson, University College London
  • Book: Neonatal Cerebral Investigation
  • Online publication: 07 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544750.013
Available formats
×