Concluded Case

Congenital Hydrocephalus with Aqueductal stenosis.Arachnoid cyst pos.f

New case 3 months old ,F ,baby ref from out side as a case of hydrocephalus. Born of non- consangunous parents.Denied having any antenatal problem to the mother. Full term baby born by cessarian section. Baby cried soon after birth. Neonatal jaundice, treated with phototherapy. Family noted increased size of the head ,head circumference at the time of birth was noted as 52 .2cm. No other abnormality noted by the patents. On exam playful child ,smiling ,gown gaze preference, intact ocular movements. Moving all 4 limbs normally. No significant spasticity noted . AF - not tense.Dialated veins over the scalp.Head circumference 55cm. What abnormality in the MRI brain

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Thanks for the answeres. Discussion- What abnormality in the MRI. * MRI shows gross dialatation of lateral ventricles and 3red ventricle with CSF flow study showing no demonstrable flow across the cerebral aqueduct . * Extra axial cystic lesion in the posterior fossa towards the left side with mass effect. Impression : Congeniral hydrocephalus with Aqueductal stenosis.Arachnoid cyst left posterior fossa. VP shunt( LP - CHHABRA) done under GA. Child is discharged by the Neurosurgeon with the advise- follow up Neurosurgery .

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Congenital hydrocephalus. Almost whole of the cerebral tissue has been compression by the enlarging hydrocephalus. Aqueductal stenosis seems to be the cause. Infant- urgently requires a Ventriculo - peritoneal shunt ( Upadhya 's shunt ) . So - refer him to neurosurgeon Rule out L1 - syndrome

Patient is under the Neurosurgeon, and Rt ventricular VP shunt done on yesterday
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Thanks for the answeres. Discussion- What abnormality in the MRI. * MRI shows gross dialatation of lateral ventricles and 3red ventricle with CSF flow study showing no demonstrable flow across the cerebral aqueduct . * Extra axial cystic lesion in the posterior fossa towards the left side with mass effect. Impression : Congeniral hydrocephalus with Aqueductal stenosis.Arachnoid cyst left posterior fossa. VP shunt( LP - CHHABRA) done under GA. Child is discharged by the Neurosurgeon with the advise- follow up Neurosurgery .

Can i hear operated docs comments. About the role of 3rd ventruculostomy in this context

Arbind chiari malformation

Ref to neurosurgery for VP shunt for better neurological outcome. May prescribe Acetazolamide for the time being