Hydranencephaly: Observations on Transillumination of the Head of Infants

Abstract

The technique of observing light shining through the head of an infant is not new, but in view of its value as a diagnostic method and as a prognostic sign, if positive, it has been neglected by neurologists and pediatricians. In 1831 Richard Bright1 described the case of James Cardinal: "If a candle was held behind his head or the sun happened to be behind it, the cranium appeared semitransparent; and this was more or less evident until he obtained his fourteenth year." This person, with a grossly enlarged head, lived to the age of 29, walked at the age of 6 years for the first time, and, in fact, learned to read and write. He was, however, obviously retarded and suffered from epileptic seizures. The autopsy, beautifully illustrated in Bright's text, disclosed a huge cranium filled with clear fluid and only a vestigial cortex present at the base of a huge cavity. This case is unusual in many ways, not only in the accurate observations of Sir Richard Bright, but also in the age to which the patient survived and the degree to which he could learn in spite of obviously severe brain deficiency. Cruveilhier * termed this condition "hydroanencephaly." Hamby, Krauss. and Beswick,8 who made very astute

Clinical use of transillumination.

“…The patient has been asymptomatic since with normal intellectual assessments at 18 months and 26 183 strobe light To power supply Comment. The medical curiosity, hydranencephaly or absence of the brain, can be suspected by transillumination (Alexander, Davis, and Kitahata, 1956). However, we have observed 4 children with transillumination patterns suggestive of hydranencephaly, but with normal or near normal development for 2 to 4 years, following successful CSF decompression.…”

Clinical use of transillumination.

“…The patient has been asymptomatic since with normal intellectual assessments at 18 months and 26 183 strobe light To power supply Comment. The medical curiosity, hydranencephaly or absence of the brain, can be suspected by transillumination (Alexander, Davis, and Kitahata, 1956). However, we have observed 4 children with transillumination patterns suggestive of hydranencephaly, but with normal or near normal development for 2 to 4 years, following successful CSF decompression.…”

TRANSILLUMINATION OF THE SKULL IN INFANTS AND CHILDREN Recording with a New Point Scale

“…All the newborn infants in our test group illuminated frontotemporally the field marked with one point (l), and in no case was there illumination over the peripheral circular marking of this field. Parietooccipitally, all the infants illuminated the central circular marking (0.5) as well as a few mm of the field marked point one (1). The upper normal range of transillumination findings according to Svenningsen (14, IS) in normal newborn babies and infants is indicated by the gray field for the frontal region (up to scale point 2), and for the parietooccipitally region by the dotted field in the figure (up to scale point 1).…”

“…The anatomical condition permitting transillumination is the presence of cledr fluid within one cm of the inner surface of the skull (1,11,13).…”

Chronic Decerebrate State in Infancy

“…It may be suspected in the newborn by cranial transillumination, which generally indicates a cerebral thickness of less than 1 cm. 1,2 Although this finding implies that such infants have varying levels of decerebration or decortication in a state sometimes permitting long survival, little attention has been paid to the clinical-physiologic features of hydranencephaly and related disorders with severe bilateral cerebral destruction or malformation. Despite many studies of the behavior of the normal newborn3-9 and also of the variable sequences of changes in common spastic diplegia10-12 little can be found concerning the neuroanatomic basis of such common neonatal activity as the Moro and the stepping reflexes.…”

Clinical use of transillumination.

“…The patient has been asymptomatic since with normal intellectual assessments at 18 months and 26 183 strobe light To power supply Comment. The medical curiosity, hydranencephaly or absence of the brain, can be suspected by transillumination (Alexander, Davis, and Kitahata, 1956). However, we have observed 4 children with transillumination patterns suggestive of hydranencephaly, but with normal or near normal development for 2 to 4 years, following successful CSF decompression.…”

TRANSILLUMINATION OF THE SKULL IN INFANTS AND CHILDREN Recording with a New Point Scale

“…All the newborn infants in our test group illuminated frontotemporally the field marked with one point (l), and in no case was there illumination over the peripheral circular marking of this field. Parietooccipitally, all the infants illuminated the central circular marking (0.5) as well as a few mm of the field marked point one (1). The upper normal range of transillumination findings according to Svenningsen (14, IS) in normal newborn babies and infants is indicated by the gray field for the frontal region (up to scale point 2), and for the parietooccipitally region by the dotted field in the figure (up to scale point 1).…”

“…The anatomical condition permitting transillumination is the presence of cledr fluid within one cm of the inner surface of the skull (1,11,13).…”

Chronic Decerebrate State in Infancy

“…It may be suspected in the newborn by cranial transillumination, which generally indicates a cerebral thickness of less than 1 cm. 1,2 Although this finding implies that such infants have varying levels of decerebration or decortication in a state sometimes permitting long survival, little attention has been paid to the clinical-physiologic features of hydranencephaly and related disorders with severe bilateral cerebral destruction or malformation. Despite many studies of the behavior of the normal newborn3-9 and also of the variable sequences of changes in common spastic diplegia10-12 little can be found concerning the neuroanatomic basis of such common neonatal activity as the Moro and the stepping reflexes.…”

Clinical use of transillumination.

“…The patient has been asymptomatic since with normal intellectual assessments at 18 months and 26 183 strobe light To power supply Comment. The medical curiosity, hydranencephaly or absence of the brain, can be suspected by transillumination (Alexander, Davis, and Kitahata, 1956). However, we have observed 4 children with transillumination patterns suggestive of hydranencephaly, but with normal or near normal development for 2 to 4 years, following successful CSF decompression.…”

TRANSILLUMINATION OF THE SKULL IN INFANTS AND CHILDREN Recording with a New Point Scale

“…All the newborn infants in our test group illuminated frontotemporally the field marked with one point (l), and in no case was there illumination over the peripheral circular marking of this field. Parietooccipitally, all the infants illuminated the central circular marking (0.5) as well as a few mm of the field marked point one (1). The upper normal range of transillumination findings according to Svenningsen (14, IS) in normal newborn babies and infants is indicated by the gray field for the frontal region (up to scale point 2), and for the parietooccipitally region by the dotted field in the figure (up to scale point 1).…”

“…The anatomical condition permitting transillumination is the presence of cledr fluid within one cm of the inner surface of the skull (1,11,13).…”

Chronic Decerebrate State in Infancy

“…It may be suspected in the newborn by cranial transillumination, which generally indicates a cerebral thickness of less than 1 cm. 1,2 Although this finding implies that such infants have varying levels of decerebration or decortication in a state sometimes permitting long survival, little attention has been paid to the clinical-physiologic features of hydranencephaly and related disorders with severe bilateral cerebral destruction or malformation. Despite many studies of the behavior of the normal newborn3-9 and also of the variable sequences of changes in common spastic diplegia10-12 little can be found concerning the neuroanatomic basis of such common neonatal activity as the Moro and the stepping reflexes.…”