The size of the intra- and extraventricular cerebrospinal fluid compartments in children with idiopathic benign widening of the frontal subarachnoid space

Abstract

The aim of this study was to quantify the intra- and extraventricular cerebrospinal fluid (CSF) spaces in children with benign enlargement of the frontal subarachnoid space (BE). The infra- and supratentorial CSF compartments were measured in 61 CT examinations of children with BE, 3-27 months old, and compared with those of 96 CT examinations considered normal. Measurements of the ventricular system, and the pontine and chiasmatic cisterns were related to cranial size. In all children with BE the lateral and third ventricles were dilated and the chiasmatic cistern was widened. The subarachnoid space was wider than the upper limits in the control group, in the frontal region (4 mm), and the anterior interhemispheric (4 mm) and Sylvian (3 mm) fissures. The infratentorial CSF compartments, the occipital subarachnoid space, the posterior part of the interhemispheric fissure and, in most cases, the cortical sulci were normal in size in children with BE. The majority were macrocephalic or had rapid head growth but there were also normocephalic children with normal head growth. The size of the posterior fossa was within the normal range in all children with BE. Idiopathic BE is not uncommon in children up to about 3 years old who are healthy or have minimal neurological disturbance and is characterised by a specific pattern of widening of the supratentorial CSF compartments.

Idiopathic normal pressure hydrocephalus may be a “Two Hit” disease: Benign external hydrocephalus in infancy followed by deep white matter ischemia in late adulthood

“…This is a condition detected by modern pediatricians on the basis of increasing head circumference out of proportion to increase in body weight and length (9,10). The cause is supposedly immature arachnoid villi that cannot resorb CSF as quickly as it is produced by the choroid plexus.…”

“…It has been stressed that it is important for radiologists to recognize this entity since it is "fairly common" (22) and selflimited and the children do not require ventricular shunting. As the name suggests, it is supposedly benign (9,10).…”

“…CSF then accumulates within the ventricles and-because the sutures can still expand prior to one year of age-over the convexities in an expanded, predominantly frontal, subarachnoid space (SAS) (9,10). The infants present with increasing head circumference relative to body weight and length.…”

Prominent Extraaxial CSF Space on Cranial Ultrasound in Infants: Correlation with Neuro d evelopmental Outcome

“…It may also be an idiopathic condition of benign nature in infants with a large or rapidly growing head, and is thought to be due to disturbance in the resorption of CSF at the level of Pacchioni s granulations, possibly caused by delayed maturation of the arachnoid villi, and leading to dilatation of all subarachnoid spaces (8). Prominent EACSFS in infancy or early childhood may be a variation of normal development of the brain whereby there is a transient accumulation of CSF (10).…”

The Intracranial and Posterior Cranial Fossa Volumes and Volume Fractions in Children: A Stereological Study

“…Abnormal changes in the size of the PCF or its contents associated with malformations or functional defects are usually assessed qualitatively. Normative data for the PCFV could be of value in the study of diseases that cause alterations in the size of the PCF (Prassopoulos et al, 1995). A fundamental knowledge of normal anatomy of this region is important to the clinician for diagnosis and treatment (Jha et al, 2008).…”