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Intrauterine Hydrocephalus and Ventriculomegaly: Associated Abnomalies and Fetal Outcome

Published online by Cambridge University Press:  18 September 2015

D. D. Cochrane*
Affiliation:
Department of Clinical Neurosciences
S. T. Myles
Affiliation:
Department of Clinical Neurosciences
C. Nimrod
Affiliation:
Departments of Obstetrics and Gynecology, University of Calgary
D. K. Still
Affiliation:
University of Alberta
R. G. Sugarman
Affiliation:
University of Saskatchewan
B. K. Wittmann
Affiliation:
University of British Columbia, Faculties of Medicine, Calgary, Edmonton, Saskatoon, Vancouver
*
Suite 207, 803-1 Avenue N.E., Calgary, Alberta, Canada T2E 7C5
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Abstract:

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Advances in fetal diagnostic techniques have opened many areas to prenatal anatomical scrutiny. Intrauterine hydrocephalus and ventriculomegaly are conditions which are readily diagnosed. Fetal intervention has been undertaken in humans in order to minimize the craniofacial disfigurement and to maximize the growth potential of the brain. To justify such an approach, the significance of all anomalies should be recognized prior to treatment. The authors have reviewed 41 cases of hydrocephalus diagnosed in utero in order to define associated anomalies and patient outcome.

75% of our personal series and 72% of the reviewed literature cases had other anomalies of the central nervous system. Other system malformations, some of which proved fatal, were seen commonly. Prenatal diagnostic techniques did not always reveal these additional problems.

The outcome of these pregnancies is not good. Approximately one third of these fetuses have survived to be treated postnatally and to be followed up clinically. Only 7.5% of this series were felt to have attained normal developmental milestones. The remainder of the survivors have various focal and/or global cerebral deficits.

Type
Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1985

References

1. Birnholtz, JC, Frigoletto, FD (1981) Antenatal Treatment of Hydrocephalus. N Engl J Med 303: 10211023.CrossRefGoogle Scholar
2. Bland, RS, Nelson, LH, Meiss, PJ, Weaver, RL, Abramson, JS (1983) Gonococcal ventriculitis associated with ventriculoamniotic shunt placement. Am J Obstet Gynecol 147: 781784.CrossRefGoogle ScholarPubMed
3. Borno, RP, Bon Tempo, NC, Kirkendall, HL, et al. (1978) Vaginal frank breech delivery of a hydrocephalic fetus after transabdominal encephalocentesis. Am J Obstet Gynecol 132: 336338.CrossRefGoogle ScholarPubMed
4. Campbell, S, Grundy, M, Singer, JD (1976) Early antenatal diagnosis of spina bifida in a twin fetus by ultrasound examination and AFP determination. Br Med J 2: 676678.CrossRefGoogle Scholar
5. Chervenak, FA, Isaacson, G, Mahoney, MJ, et al. (1984) The obstetrical significance of holoprosencephaly. Obstet Gynecol 63:115121.Google ScholarPubMed
6. Clewell, WH, Johnson, ML, Meirer, PR, et al. (1982) A surgical approach to the treatment of fetal hydrocephalus. N Engl J Med 306: 13201325.CrossRefGoogle Scholar
7. Dempsey, PJ, Koch, HJ (1981) In utero diagnosis of the Dandy-Walker Syndrome: Differentiation from extraxial posterior fossa cyst. J Clin Ultrasound 9: 403405.CrossRefGoogle Scholar
8. Depp, R, Sabbagha, RE, Brown, JT, et al. (1983) Fetal surgery for hydrocephalus: Successful in utero ventriculoamniotic shunt for the Dandy-Walker syndrome. Obstet Gynecol 61: 710714.Google ScholarPubMed
9. Fileni, A, Colosimo, C, De Gaetano, AM, et al. (1983) Dandy-Walker Syndrome: Diagnosis in utero by means of ultrasound and CT correlations. Neuroradiology 24: 233235.CrossRefGoogle ScholarPubMed
10. Freeman, RK, McQuown, DS, Secrist, LJ, et al. (1977) The diagnosis of fetal hydrocephalus before viability. Obstet Gynecol 49:109112.Google ScholarPubMed
11. Frigoletto, FD, Birnholtz, JC, Greene, MF (1982) Antnatal treatment of hydrocephalus by ventriculoamniotic shunting. JAMA 248: 24962497.CrossRefGoogle ScholarPubMed
12. Gray, R, Barrie, H (1978) Decompression of hydrocephalus during delivery. Lancet 2: 52.CrossRefGoogle ScholarPubMed
13. Hartikainen-Sorri, A, Kirinen, P, Herva, R (1983) Prenatal detection of the Hydrolethalus Syndrome. Prenat Diagn 3: 219224.CrossRefGoogle ScholarPubMed
14. Hartung, RW, Yiu-Chiu, V (1983) Demonstration of unilateral hydrocephalus in utero. J Ultrasound Med 2: 369371.CrossRefGoogle ScholarPubMed
15. Hatjis, CG, Horbar, JD, Anderson, GG (1981) The in utero diagnosis of a posterior fossa intracranial cyst. AM J Obstet Gynecol 140: 473475.CrossRefGoogle ScholarPubMed
16. Hyndman, J, Johri, AM, MacLean, NE (1980) Diagnosis of fetal hydrocephalus by ultrasound. NZ Med J 91: 385386.Google ScholarPubMed
17. Jorgensen, C, Ingemarsson, I, Svenningsen, NW (1983) Prenatal diagnosis of fetal brain ventricle dilitation. Br J Obstet Gynecol 90: 162166.CrossRefGoogle Scholar
18. Kellner, KR, Cruz, AC, Gelman, SR, et al. (1980) Percutaneous fetal ventriculography. J Reprod Med 24: 225228.Google ScholarPubMed
19. Kirkinen, P, Joupilla, P, Valkeakari, T, et al. (1982) Ultrasonic evaluation of the Dandy-Walker syndrome. Obstet Gynecol 59: 185215.Google ScholarPubMed
20. Kirkinen, P, Suramo, I, Joupilla, P, et al. (1982) Combined use of ultrasound and computed tomography in the evaluation of fetal intracranial abnormality. J Perinat Med 10: 257265.CrossRefGoogle ScholarPubMed
21. Lee, TG, Warren, WH (1977) Antenatal diagnosis of hydranencephaly by ultrasound: Correlation with ventriculography and computed tomography. J Clin Ultrasound 5: 271273.CrossRefGoogle ScholarPubMed
22. Newman, GC, Buschi, AL, Sugg, NK, et al., Miller, JQ (1982) Dandy-Walker syndrome diagnosed in utero by ultrasonography. Neurology 32: 180184.CrossRefGoogle ScholarPubMed
23. Osathanondh, R, Birnholtz, JC, Altman, AM, et al. (1980) Ultrasoni-cally guided transabdominal encephalocentesis. J Reprod Med 25: 125128.Google ScholarPubMed
24. Patterson, JA, Gold, WR, Sanz, LE, et al. (1981) Antenatal evaluation of fetal hydrocephalus with computed tomography. Am J. Obstet Gynecol 140; 344345.CrossRefGoogle ScholarPubMed
25. Reed, MF (1972) Ultrasound in diagnosing hydrocephalus. B Med J 3: 762.CrossRefGoogle ScholarPubMed
26. Robertson, CH, Lund, RR, Soroosh, F, et al. (1969) Percutaneous fetal ventriculography. Obstet Gynecol 34: 841846.Google ScholarPubMed
27. Robertson, RD, Sarti, DA, Brown, WJ (1981) Congenital hydrocephalus in two pregnancies following the birth of a child with a neural tube defect: etiology and management. J Med Genetics 18: 105107.Google Scholar
28. Salonen, R, Herva, R, Norio, R (1981) The hydrolethalus syndrome: dellineation of a “new” lethal malformation based on 28 patients. Clin Genetics 19: 321330.CrossRefGoogle ScholarPubMed
29. Van Egmond-Linden, A, Wladimiroff, J W, Jahoda, MCJ, et al. (1983) Prenatal diagnosis of X-linked hydrocephaly. Prenat Diagn 3:219224.CrossRefGoogle ScholarPubMed
30. Chervenak, FA, Duncan, C, Ment, LR, et al. (1984) Outcome of Fetal Ventriculomegaly. Lancet 2 (8396) : 179181.CrossRefGoogle ScholarPubMed
31. Glick, PL, Harrison, MR, Nakayama, DK (1984) The management of ventriculomegaly in the fetus. J Pediatr 105: 97105.CrossRefGoogle ScholarPubMed
32. Garrett, WJ, Fisher, CC, Kossoff, G (1975) Hydrocephaly, microcephaly and anencephaly diagnosed in pregnancy by ultrasonic echography. Med J Aust 2: 587589.CrossRefGoogle ScholarPubMed
33. Denkhaus, H, Winsberg, F (1979) Ultrasonic measurement of the fetal ventricular system. Radiology 131: 781787.CrossRefGoogle ScholarPubMed
34. Dunne, MG, Johnson, ML (1979) The ultrasonic demonstration of fetal abnormalities in utero. J Reprod Med 23: 195206.Google ScholarPubMed
35. Hobbins, JC, Grannun, PAT, Berkowitz, RL, et al. (1979) Ultrasound in the diagnosis of congenital anomalies. Am J Obstet Gynecol 134: 331345.CrossRefGoogle ScholarPubMed
36. Jeanty, P, Dramaix-Wilmet, M, Delbeke, D, et al. (1981) Ultrasonic evaluation of fetal ventricular growth. Neuroradiology 21:127131.CrossRefGoogle ScholarPubMed
37. Hidalgo, H, Bowie, J, Rosenberg, ER, et al. (1982) In utero sonographic diagnosis of fetal cerebral anomalies. Am J Radiol 139: 143148.Google ScholarPubMed
38. Campbell, S, Pearce, JM (1983) Ultrasound visualization of congenital malformations. Br Med Bull 39: 322331.CrossRefGoogle ScholarPubMed
39. Campbell, S (1977) Early prenatal diagnosis of neural tube defect by ultrasound. Clin Obstet Gynecol 20: 351359.CrossRefGoogle ScholarPubMed
40. Chinn, DH, Callen, PW, Filly, RA (1983) The lateral cerebral ventricle in early second trimester. Radiology 148: 529531.CrossRefGoogle ScholarPubMed
41. Hill, LM, Breckie, R, Gehrking, WC (1983) The prenatal detection of congenital malformations by ultrasonography. Mayo Clin Proc 58: 805826.Google ScholarPubMed
42. McGahan, JP, Phillips, HE (1983) Ultrasonic evaluation of the size of the trigone of the fetal lateral ventricle. J Ultrasound Med 2: 315319.CrossRefGoogle Scholar
43. Ferry, PC, Pernoll, ML (1976) The rational management of perinatal hydrocephalus. Am J Obstet Gynecol 126: 151152.CrossRefGoogle ScholarPubMed
44. Benke, P, Strassberg, R (1980) Prenatal study of X-linked aqueductal stenosis. J Med Genetics 17: 158.CrossRefGoogle ScholarPubMed
45. Johnson, ML, Pretorius, D, Clewell, WH, et al. (1983) Fetal hydrocephalus: diagnosis and management. Semin Perinatol 7: 8389.Google ScholarPubMed
46. Nulsen, FE, Rekate, HL (1982) The results of treatment for hydrocephalus as a guide for future management. In: Pediatric Neurosurgery: Surgery of the Developing Nervous System. Grune and Stratton, New York, pp 229241.Google Scholar
47. McCullough, DC, Balzer-Martin, LA (1982) Current prognosis in overt neonatal hydrocephalus. J Neurosurg 57: 378383.CrossRefGoogle ScholarPubMed
48. McLone, DG (1982) Congenital Malformation of the Brain. In: Pediatric Neurosurgery: Surgery of the Developing Nervous System. Grune and Stratton, New York, pp 105107.Google Scholar
49. Sawaya, R, McLaurin, RL (1981) Dandy-Walker Syndrome. Clinical analysis of 23 cases. J Neurosurg 55: 8997.Google ScholarPubMed
50. Tal, Y, Freigang, B, Dunn, HG, et al. (1980) Dandy-Walker Syndrome. Analysis of 21 cases. Dev Med Child Neurol 22: 189201.CrossRefGoogle ScholarPubMed
51. Edwards, JH, Norman, RM, Roberts, JM (1961) Sex linked hydrocephalus: report of a family with 15 affected members. Arch Dis Child 36: 481485.CrossRefGoogle ScholarPubMed
52. Kelley, RI, Zackai, EH, Mennuti, MT, et al. (1982) Treatment of fetal hydrocephalus. New Engl J Med 307: 1211 (Letter).Google Scholar
53. Donn, SM (1982) Fetal hydrocephalus—a perinatal dilemma. J Reprod Med 27: 589592.Google ScholarPubMed
54. Mealey, J, Gilmor, RL, Budd, MP (1973) The prognosis for hydrocephalus overt at birth. J Neurosurg 39: 348355.CrossRefGoogle ScholarPubMed
55. Sunder, TR (1981) Antenatal treatment of hydrocephalus. New Engl J. Med 305: 403 (Letter).Google ScholarPubMed
56. Cochrane, DD, Myles, ST (1982) Management of intrauterine hydrocephalus. J Neurosurg 57: 590596.CrossRefGoogle ScholarPubMed
57. Cochrane, DD, Myles, ST (1983) Management of intrauterine hydrocephalus. J Neurosurg 58: 793 (Letter).Google Scholar
58. Venes, JL (1983) Management of intrauterine hydrocephalus. J Neurosurg 58: 793 (Letter).Google ScholarPubMed
59. Hollister, A, Tsiarar, A (1983) The Unborn Patient. Life 6: 3844.Google Scholar
60. Hoffman, HJ (1982) Technical Problems in Shunts. In: Shunts and Problems in Shunts. Karger, Basel, pp 158169.Google Scholar