Spontaneous brain rupture: a complication of untreated hydrocephalus

Unusual Complication of Neglected Hydrocephalus: Spontaneous Rupture with Growing Skull Fracture

“…The other contributing factors are limited resistance of surrounding white matter and convex/concave geometry of the ventricular walls. Persistently raised intracranial pressure leads to ependymal rupture at the sides of the frontal and occipital horns [3,9,10,11]. Another confounding factor is the disproportionate weight of the increased head size in a malnourished infant.…”

“…With the sudden release of intracranial pressure, the collapse of the ventricular system creates an unsightly depression over the vertex, leading to an ‘alien head' appearance. In extreme cases, brain matter may also herniate through the defect [2,3,4,5,6,7]. …”

“…Of the 5 cases in total, 4 patients had presented in the first year of life; 2 infants were suffering with HCP with meningomyelocele (Chiari II malformation), while the remaining 3 (including the index case) were cases of congenital aqueductal stenosis. In all cases, parental reluctance and refusal of surgery at earlier consultation was the reason for this dreadful complication [2,3,4,5,6,7,8]. …”

“…We describe such a case of neglected HCP with spontaneous external rupture of ventricles leaking cerebrospinal fluid (CSF) and growing skull fracture. The literature is also reviewed for neglected cases of pediatric HCP with spontaneous internal or external rupture [2,3,4,5,6,7,8]. …”

Some Challenging Points for Neurosurgeons in Low-Income Developing Countries

“…8 The operation of an adolescent patient with long-lasting increased intracranial pressure secondary to a brain tumor with no light perception in both eyes has been reported. We reported a small kid with spontaneous brain rupture, a complication of untreated hydrocephalus.…”