32 weeks gestation with dilated ventricle left lateral ventricle 13mm and right lateral ventricle 11mm , no spinal abnormity ,TORCH serology negative, how to Proceed?
Preterm delivered because they thought child needs urgent treatment
Child was delivered at 36weeks Anterior frontanelle lax head circumference 33cms USG head done on day 1
figure 2 and 3
MRI brain done on day 4
fingures 4 ,5,6,
When the child first seen by me at day 6 age It was reported hydrocephalus came for surgical intervention took lot of time to convince the family no intervention is warranted
Child was asymptomatic,we wait andmonitor head circumference and developmental milestones .
At 3 months hc 39cms Af lax development appropriate
figures 7,8,9
Discussions
1 Antenatally Very important to see biparietal diameter and head circumference.we cannot comment on single report unless we have serial scan to see the rate of change
Figure 10
2 Mild Unilateral ventriculomegaly,If no other associated malformations, it is usually benign. Though almost 20% can have mild IQ deficit so require serial developmental milestones charting
Moral of Story
1 Do not panic just on usg report
2 Look for appropriate biparietal diameter and head circumference
3 Not all dilation of ventricle are bad
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