Benign Enlargement of Subarachnoid Space in Infancy: “A Review with
Iranian Journal of Child Neurology,
Vol. 12 No. 4 (2018),
1 Mehr 2018
,
Page 7-15
https://doi.org/10.22037/ijcn.v12i4.21317
Abstract
Objective:
Macrocephaly are among the most frequent reasons for referral to a pediatric neurologist.
Benign enlargement of subarachnoid spaces (BESS) in infancy is a most common cause of macrocephaly and is characterized by excess cerebrospinal fluid (csf) in the subarachnohd spaces.
In this review, we described epidemiology, etiology, clinical presentation, pathogenesis, neuroimaging, treatment and outcome of entity from current literature.
Materials & Methods
We searched the related papers in electronic databases such as Google Scholar, PubMed, and Scopus .
Key words for searching were benign enlargement of subarachnoid spaces in infancy, external hydrocephaly and neuroimaging.
Results
The related data focusing on the etiology, epidemiology, clinical presentation, differential diagnosis, neuroimaging, treatment and outcome with emphasis on diagnostic work up were gathered and described.
Conclusion
BESS is most common cause of macrocephaly in infancy . It is characterized dy macrocephaly , excess csf in subarachnoid spaces and normal ventricles or mild ventricolomegaly. Self-limited disorder in infancy ,mostly in male and with familial tendency and normal or mildly delay motor or language delay.
Mostly favorable prognosis without need treatment.
Neuroimaging is essential for diagnosis and selection of useful tool and close observation of patient is necessary and sufficient for follow up. It is best way from economic points and reduce hazards of inappropriate neuroimaging.
- Benign enlargement of subarachnoid space
- Benign external hydrocephaly
- Neuroimaging
How to Cite
References
Pediatric Head Imaging Guidelines. Macrocephaly, Microcephaly, Hydrocephaly and Related Conditions. Version 17: 02-16-2015
Disorders of cranial volume and shape. Pina-Garza JE, Fenichel GM. Fenichel's Clinical Pediatric Neurology: A sign & Symptoms Approach. Elsevier.2013:348-51
Haws MD, Linscot L, Thomas C, Orscheln E, Radhakrishnan R, Kline-Fath BK. A retrospective analysis of the utility of head computed tomograghy and/or magnetic resonance imaging in the management of benign macrocrania. J Pediatr 2017;182:283-9
Kuruvilla LC, Benign enlargement of subarachnoid spaces in infancy. J Pediatr Neurosci 2014;9(2):129-31
Zahi SM, Egge A, Helseth E, Wester K. Benign external hydrocephalus: a review, with emphasis on management. Neurosurg Rev 2011;34(4):417-32
Hamden AA, Drake JM.Hydrocephalus and Arachnoid cysts. Swaiman KF, Ashwal S, Ferriero DM.Swaiman's Pediatric Neurology "Principles and Practice".Elsevier 2017:e561-9
1.Kumar.R. External hydrocephalus in small children. Childs Nerv Syst.2006;22:1237-41
Marino MA, Morabito R, Vinci S, Germano A, Briqugio M, Alafaci C, et al. Benign external hydrocephalus in infants. A single centre experience and literature review. Neuroradiol J 2014; 27(2)245-50.
Nelson SL, Johnston MV. Extracerebral fluid collections in infants. MedLink Neurology2016
Alvarez LA, Maytal J,Shinnar S. Idiopathic external hydrocephalus: natural history and relationship to benign familial macrocephaly.Pediatircs.1986;77:901-7
Hamza M, Bodensteiner JB, Noorani PA, Barnes PD. Benign extracerebral fluid collections: A cause of macrocrania in infancy. Pediatr Neurol 1987;3(4):218-21
Alper G, Ekinci G, Yilmaz Y, Arikan C, Telyer G, Erzen C. Magnetic resonance imaging characteristics of benign macrocephaly in children. J Child Neurol.1999;14(10):678-6
Castro-Gago M, Perez-Gomez C, Novo-Rodriguez MI, Blanco-Barca O, Alonso-Martin A, Eiris-Punal J. Benign idiopathic external hydrocephalus (benign subdural collection) in 39 children: natural history and relationship to familial macrocephaly. Rev Neurol 2005;40(9):513-7
Hellbusch LC. Benign extracerebral fluid collections in infancy: clinical presentation and long-term follow-up. J Neurosurg 2007;107(2): 119-25
.Suara RO, Trouth AJ, Collins M. Benign subarachnoid space enlargement of infancy. J Natl Med Assoc 2001;93(2)70-3
Wiig US, Zahl SM, Egge A, Helseth E, Wester K. Epidemiology of Benign External Hydrocephalus in Norway-A population –Based Study. Pediatr Neurol.2017;73:36-41
Asch AJ, Myers GJ. Benign familial macrocephaly: report of a family and review of the Literature .Pediatrics.1976;57:535-9
Arbour L,Watters GV, Hall JG, Fraser FC. Multifactorial inheritance of non- syndromic macrocephaly . Clin Genet.1996;50-62
Gupta SN, Belay B. Intracranial incidental findings on brain MR images in a pediatric neurology practice: a retrospective study. J Neurol Sci.2008;264:34-7
Dandy WE, Blackfan KD. An experimental and clinical study of internal hydrocephalus.JAMA 1913;61:2216-7
Mikkelsen R, Rodevand LN, Wiig US, Zahl SM, Berntsen T, Skarbo AB, et al. Neurocognitive and psychosocial function in children with benign external hydrocephalus(BEH)-a long-term follow-up study. Childs Nerv Syst.2017;33(1)91-99
Andersson H, Elfverson J, Svendsen P. External hydrocephalus in infants. Childs Brain.1984;11:398-402
Gooskens RH, Willemse J, Faber JA, Verdonck AF. Macrocephalies-a differentiated approach. Neuropediatrics. 1989;20:164-9
.Laubscher B, Deonna T, Uske A, Melle G. Primitive megalencephaly in children: natural history, medium term prognosis with special reference to external hydrocephalus. Eur J Pediatr.1990;149:502-7
Ment LR, Duncan CC, Geehr R. Benign enlargement of the subarachnoid spaces in the infant.1981;54(4):504-8
Barlow CF. CSF dynamics in hydrocephalus .Brain Dev .1984;6:119-27
Kendall B, Holland I, Benign communicating hydrocephalus in children . Neuroradiology.1981;21:93-6
Piatt J. Monozygotic twins discordant for external hydrocephalus. Pediatr Neurosurg.2001;35:211-5
Girard N, Gire C, Sigaudy S, Porcu G, d’Ercole C, Figarella-Branger D. MR imaging of acquired fetal brain disorders. Childs Nerv Syst.2003;19:490-500
Maytal J, Alvarez LA, Elkin CM, Shinnar S. External hydrocephalus: radiologic spectrum and differentiation from cerebral atrophy. AJR Am J Roentgenol.1987;148:1223-30
Lorber J, Priestly BL. Children with large head: a practical approach to diagnosis in 557 children, with special reference to 109 children with megalencephaly. Dev Med Child Neurol.1981;23:494-504
Shen MD, Nordahl CW, Young G S. Wootton-Gorges SL, Lee A, Liston SE. Early brain enlargement and elevated extra-axial fluid in infants who develop autism spectrum disorder.Brain 2013;136(9):2825-35
31.Mcneely PD, Atkinson JD, Saigal G, O’Gorman AM, Farmer JP.Subdural hematomas in infants with benign enlargement of the subarachnoid spaces are not pathognomonic for child abuse.Am J Neuroradiol.2006;27(8)1725-28
Tucher J, Choudhary AK, Piatt J. Macrocephaly in infancy: benign enlargement of the subarachnoid spaces and subdural collections. J Neurosurg Pediatr 2016;18:16-20
Paciorkowski AR, Greenstein RM. When is enlargement of the subarachnoid spaces not benign? A genetic perspective. Pediatr Neurol 2007;37:1-7
Smith R, Leonidas JC, Maytal J, The value of head ultrasound in infants with macrocephaly.Pediatr Radiol 1998;28:143-6
Fessell DP, Frankel DA, Wolfson WP. Sonography of extraaxial fluid in neurologically normal infants with head circumference greater than or equal the 95th percentile for age. J Ultrasound Med.2000;19:443-7
Lam WW, Ai VH, Wong V, Leong LI. Ultrasonographic measurement of subarachnoid space in normal infants and children. Pediatr Neurol.2001;25:380-4
Hamza M, Bodensteiner JB, Noorani PA, Barnes PD. Benign extracerebral fluid collections: A case of macrocrania in infancy.Pediatr Neurol 1987;3(4):218-21
Kurata H, Shirai K, Saito Y, Okazaki T, Ohno K, Oguri M, et al.Neurodevelopmental disorders in children with macrocephaly: A prevalence study and PTEN gene analysis. Brain Dev 2018;40:36-41
Chen CY, Chou TY, Zimmerman RA, Lee CC, Chen FH, Faro SH. Pericerebral fluid collection: differentiation of enlarged subarachnoid spaces from subdural collections with color Doppler US.Radiology,1996;201(2):389-92
Wilms G, Vanderschueren G, Demaerel PH, Smet MH, Plets C, Goffin J et al. CT and MR in infants with pericerebral collections and macrocephaly: benign enlargement of the subarachnoid spaces versus subdural collections .Am J Neuroradiol 1993; 14(4):855-60
Aoki N.Extracerebral fluid collections in infancy: role of magnetic resonance imaging in differentiation between subdural effusion and subarachnoid space enlargement. J Neurosurg 1994;81(1):20-3
Fisher PG. Does macrocephaly require MRI, CT, ultrasound, or a tape measure? J Pediatr2017;182(5):283
Babcock DS, Han BK, Dine MS. Sonographic findings in infants with macrocrania.AJNR 1988;150:1359-65
Carolan PL, McLaurin, Towbin RB, ET AL. Benign extra-axial collections of infancy. Pediatr Neurosci 1985-1986;12:140-4
Gout A, Gautier I, Bellaiche M, Pinard JM, Tremon M, Rodriguez D, et al. Idiopathic peri-cerebral enlargement in infants: simple anatomical variant or hemorrhagic risk factor? Arch Pediatr. 1997;4:983-7
Muendhberger H, Assaad N, Joy P, Brunsdon R, Shores EA. Idiopathic macrocephaly in the infant: long –term neurological and neuropsychological outcome.2006;22(10):1242-8
Yew AY, Maher CO, Muraszko KM, Garton HJ. Long-term health status in benign external hydrocephalus. Pediatr Neurosurg.2011;47(1):1-6.
Pouplard F, Pineau P, Use of acetazolamide in external hydrocephalus in infants. Annales de Pediatrie.01 may 1990;37(5):310-2
- Abstract Viewed: 1015 times