Neurodevelopmental Outcomes of Infants with Benign Enlargement of the Subarachnoid Space
Iranian Journal of Child Neurology,
Vol. 15 No. 2 (2021),
1 March 2021
https://doi.org/10.22037/ijcn.v15i1.25309
Abstract
Objective
Benign enlargement of the subarachnoid space (BESS) is the most common cause of macrocephaly in infants. This study aimed to evaluate the neurodevelopmental outcomes in infants with BESS.
Materials & Methods
In this follow-up study, all records of infants diagnosed with BESS in 2012-2016 were assessed. A clinical follow-up examination was carried out at 6, 12, 18, and 24 months of age to assess the macrocephaly outcomes. Denver Developmental Screening Test-II (DDST-II) was used for evaluating the psychomotor development of infants at 24 months of age. All data were entered in SPSS Version 13, and descriptive statistics were measured.
Results
Out of 32 infants included in this study, 28 (87.5%) were boys. Five cases of prematurity history (15.6%), and 23 cases of macrocephaly in the family (71.9%) were recorded. The mean age of BESS diagnosis was 6.8 months (SD=3.2). subdural hematoma was reported in one infant (3.1%). Also, 28 infants showed macrocephaly at 18 months of age (83.3%). Seven patients had developmental delay, according to DDST-II (22%). The mean head circumference at birth and six months of age was significantly greater in infants with developmental delay compared to those with normal development. There was a significant difference between the mean head circumference at birth (P=0.05) and the mean head circumference at six months of age (P=0.02).
Conclusion
Developmental delay is frequent in BESS infants, especially those with macrocephaly at birth and six months of age, and requires medical attention
- Benign enlargement of the subarachnoid space; Development; External hydrocephalus; Infant; Macrocephaly
How to Cite
References
Hellbusch LC. Benign extracerebral fluid collections in infancy: clinical presentation and
long-term follow-up. J Neurosurg. 2007;107(2Suppl):119-25.
Turner L. The structure of arachnoid granulations with observations on their physiology and pathophysiological significance .Ann R Coll Surg Engl.1961;29(4):237-64
Sainz LV, Zipfel J, Kerscher SR, Weichselbaum A, Bevot A, Schuhmann MU. Cerebro-venous hypertension: a frequent cause of so-called “external hydrocephalus” in infants. Childs Nerv Syst. 2018;24(10):018-4007.
Wiig US, Zahl SM, Egge A, Helseth E, Wester K. Epidemiology of Benign External Hydrocephalus in Norway-A Population-Based Study. 2017 [cited 73]; 36-41].
Alvarez LA, Maytal J, Shinnar S. Idiopathic external hydrocephalus: natural history and relationship to benign familial macrocephaly. Pediatrics. 1986;77(6):901-7.
Halevy A, Cohen R, Viner I, Diamond G, Shuper A. Development of Infants With Idiopathic External Hydrocephalus. J Child Neurol. 2015;30(8):1044-7.
Yew AY, Maher CO, Muraszko KM, Garton HJ. Long-term health status in benign external hydrocephalus. Pediatr Neurosurg. 2011;47(1):1-6.
Muenchberger H, Assaad N, Joy P, Brunsdon R, Shores EA. Idiopathic macrocephaly in the infant: long-term neurological and neuropsychological outcome. Childs Nerv Syst. 2006;22(10):1242-8.
Amouian S, Kholus Makhtumi S, Mohammad khani M, Nomali M. Demographic features of children with external hydrocephalus at Taleghani educational & treatment center (2009-2011). Jorjani Biomedicine Journal.
;1(2):64-9.
Hassan Bella and Salih S.Factors affecting child development in Madinah,Saudi,Arabia. J Family community Med.1999;6(2):29-36
Nickel RE, Gallenstein JS. Developmental prognosis for infants with benign enlargement of the subarachnoid spaces. Developmental medicine and child neurology. 1987;29(2):181- 6. Epub 1987/04/01.
Alper G, Ekinci G, Yilmaz Y, Arikan C, Telyar G, Erzen C. Magnetic resonance imaging characteristics of benign macrocephaly in children. J Child Neurol. 1999;14(10):678-82.
Neveling EA, Truex RC, Jr. External obstructive hydrocephalus: a study of clinical and developmental aspects in ten children. J Neurosurg Nurs. 1983;15(4):255-60.
Nogueira GJ, Zaglul HF. Hypodense extracerebral images on computed tomography in children. “External hydrocephalus”: a misnomer? Childs Nerv Syst. 1991;7(6):336- 41.
Pavone P, Pratico AD, Rizzo R, Corsello G, Ruggieri M, Parano E, et al. A clinical review on megalencephaly: A large brain as a possible sign of cerebral impairment. Medicine. 2017;96(26):e6814. Epub 2017/06/29.
Pascual-Castroviejo I, Pascual-Pascual SI, Velazquez-Fragua R. [A study and followup of ten cases of benign enlargement of the subarachnoid spaces]. Rev Neurol. 2004;39(8):701-6.
Hamza M, Bodensteiner JB, Noorani PA, Barnes PD. Benign extracerebral fluid collections: a cause of macrocrania in infancy. Pediatr Neurol.
;3(4):218-21.
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: its natural history and relation to familial macrocephaly]. Rev Neurol. 2005;40(9):513-7.
Zahl SM, Egge A, Helseth E, Wester K. Benign external hydrocephalus: a review, with
emphasis on management. Neurosurg Rev. 2011;34(4):417-32.
Karimzadeh P, Tonekaboni SH, Shariatmadari F. Benign external hydrocephalus and its relation to familial megalencephaly: an analysis of 20 cases. Journal of Pediatric Neurology. 2009;7(2):157-63.
Kuruvilla LC. Benign enlargement of subarachnoid spaces in infancy. J Pediatr Neurosci. 2014;9(2):129-31.
Biswas A, Furruqh F, Thirunavukarasu S, Neelakantan S. Benign enlargement of subarachnoid spaces: a cause of subdural haemorrhage in toddlers. BMJ Case Rep. 2016; 3(215753): 2016-215753.
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. AJNR Am J Neuroradiol. 2006;27(8):1725-8.
Paciorkowski AR, Greenstein RM. When is enlargement of the subarachnoid spaces not benign? A genetic perspective. Pediatr Neurol.
;37(1):1-7. Epub 2007/07/14.
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