3 year old child with a history of gradually increasing in size of head since 2.5years. Presented to the emergency in respiratory distress. Child was not shown or taken treatment till now. Further management?



Seems to be MEGALENCEPHALY (in view of no dilated veins n sun setting sign not visible) or CONGENITAL HYDEOCEPHALOUS (due to AQUEDUCTAL STENOSIS or MALFORMATION). the parents would have started noticing by 6 months only. Acquired causes like POST MENINGITIC should also be kept in mind. CT/MRI brain ll give diagnosis. Respiratory distress means the child is having RAISED ICP so immediately manage that. He may need intubation n mechanical ventilation. Definitive treatment would be VENTRICULO PERITONEAL SHUNT after stabilisation.

Case of macro/megacephaly.. We have to access for neurodevelopmentally prior to this event. Ct scan or mri brain diagnostic tool FOR OBSTRUCTIVE HYDROCEPHALUS OR CONGENITAL.. After that we have to see CNS CAUSE FOR HYDROCEPHALUS CLINICALLY MUST BE HAVING " SUNSET SIGN". SOMETIME WR CAN SEE CYTOMEGALUS INFECTIONS HE WILL NEED V-P SHUNT

Congenital hydrocephalus

Megacephaly, congenital hydrocephalus. Neurosurgical opinion.


hydrocephalus, sunset sign not visible because eyes have been covered. CT/MRI should be done to assess the cause of hydrocephalus


Hydrocephaly. Resp distress could be due to high ICT.

Imaging please before we jump to conclusions


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