G. Wilms et al., CT AND MR IN INFANTS WITH PERICEREBRAL COLLECTIONS AND MACROCEPHALY -BENIGN ENLARGEMENT OF THE SUBARACHNOID SPACES VERSUS SUBDURAL COLLECTIONS, American journal of neuroradiology, 14(4), 1993, pp. 855-860
Citations number
19
Categorie Soggetti
Neurosciences,"Radiology,Nuclear Medicine & Medical Imaging
PURPOSE: To compare CT and MR in the differentiation of benign enlarge
ment of the subarachnoid spaces and subdural collections in infants wi
th macrocephaly. METHODS: MR was performed in 19 infants with macrocep
haly, showing bifrontal enlargement of the subarachnoid spaces on CT.
RESULTS: In 11 patients, a single fluid layer could be distinguished o
n MR of the pericerebral collections, suggesting benign enlargement of
the subarachnoid spaces. In eight patients, two separate layers were
clearly differentiated, an outer layer that was hyperintense on all se
quences and an inner layer with the same intensity as the cerebrospina
l fluid. This indicated the presence of subdural collections. These co
llections were mainly frontal in six and extended over the entire hemi
sphere in two patients. On CT, these separate lesions were seen only i
n three patients and missed in three others. In two final patients, CT
findings were equivocal with evidence of membrane formation within th
e hypodense collections. In seven patients with a subdural collection,
subdural-external drainage was performed. In three patients, the coll
ection was hemorrhagic. The protein content of the fluid showed a mean
of 1381.7 +/- 785.6 mg/dL. The MR and surgical findings of a subdural
collection correlated with the absence of a family history of macrocr
ania, an age under 5 months, and acute clinical signs of vomiting, som
nolence, and hypotonia. CONCLUSION: MR appears essential in the differ
ential diagnosis between benign enlargement of the subarachnoid spaces
and subdural collections in infants.