The Role of Computed Tomography & Ultrasound in Diagnosing Hydrocephalus In Pediatrics

Abstract

The term hydrocephalus derived from two Greek words, hydro for water and kephale for head. Hydrocephalus implies an excessive accumulation of cerebrospinal fluid (CSF) within the cavities of the brain known as ventricles. (1) Build up in CSF volume can result from interference with normal CSF circulation [due to an obstruction in the brain’s ventricular system], or as the result of a problem with CSF reabsorption. (1) In most instances, hydrocephalus is a life long condition in that the patient is treated rather than cured. Treatment by shunting the CSF to another area of the body, generally allows patients to lead full active lives. (1) Patients and their families however, should be aware of signs symptoms and complications so that medical care can be thought in a timely manner when necessary. (1) There are many method for imaging and demonstrating hyydrocephalus, such as pneumoencephlography, air ventriculography, echoencephalography and others which have been used for many years to evaluate the etiology of hydrocephalus in adults and children, but this procedures carry only a slight risk and less and not accurate information, so they become less reluctant to request for patient with early or mild signs and symptoms. (2) Now days there are most useful modalities in diagnosis, among these methods there are CT and U/S which are in our interest. 2 Ultrasound of the brain has become an integral part of care in the neonate and pediatrics in last decade, particularly among high – risk premature infants. Current U/S technology allows for rapid evaluation of infants in the intensive care nursery with no risk. New areas of U/S application are rapidly evolving. Pulsed and color Doppler imaging of cranial blood flow. (3) Computer tomography is now regarded by many as the linkpin of modern diagnostic imaging, its contrast value in many clinical situation, and its ability to provide direct information about existence and nature of intracranial pathology was quickly appreciated and made the indirect imaging technique such as ventriculography obsolete. (4) The introduction of CT has enabled investigators to evaluate brain structure and ventricular size by a safe and non invasive technique accurate assessment of CSF dynamics is possible if CT is performed after the intrathecal introduction of a water – soluble contrast agent. These diagnostic technique have stopped the need for pneumography in evaluation of patients with suspected hydrocephalus. The neuroradiologist must study the patient carefully and then decide how to achieve the most accurate radiologic information with the least morbidity, the least radiation exposure and the least cost to the patient, and as we know the early diagnosis of patholoigc condition in the brain may greatly affect patient treatment planning and management. (2)