Smith R, Leonidas J C, Maytal J
Division of Pediatric Neurology, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA.
Pediatr Radiol. 1998 Mar;28(3):143-6. doi: 10.1007/s002470050315.
To assess the value of head ultrasound (HUS) in neurologically normal infants with macrocephaly and to develop a rational approach to radiological investigation of macrocephalic infants.
A retrospective analysis of infants with macrocephaly (seen by one pediatric neurologist at this institution) was conducted. Infants with normal neurological examinations, no evidence of raised intracranial pressure and who had undergone a HUS were included.
Twenty-seven infants were included in the analysis. Mean age at first assessment was 4.8 months. In 12 of 27 (44%), HUS was reported as normal. The remaining 15 had clinically insignificant abnormalities on HUS; 7 had prominent ventricles and 7 had increased subarachnoid fluid, with 1 infant having both. Seven infants had CT or MRI in addition to HUS. No clinically significant abnormalities were seen on CT or MRI scans that were not evident on HUS. Four infants had mild developmental abnormalities on initial evaluation. Mean duration of follow-up was 13.1 months. No infant developed neurological abnormalities during the follow-up period.
In infants with macrocephaly with a normal neurological examination and no signs of raised intracranial pressure, HUS in conjunction with close neurological follow-up is reliable for the detection or exclusion of relevant intracranial pathology.
评估头部超声（HUS）在神经系统正常的巨头畸形婴儿中的价值，并制定对巨头畸形婴儿进行放射学检查的合理方法。
对巨头畸形婴儿（由该机构的一名儿科神经科医生诊治）进行回顾性分析。纳入神经系统检查正常、无颅内压升高证据且接受过HUS检查的婴儿。
27例婴儿纳入分析。首次评估时的平均年龄为4.8个月。27例中有12例（44%）HUS报告正常。其余15例HUS有临床意义不显著的异常；7例脑室扩大，7例蛛网膜下腔积液增多，1例两者均有。7例婴儿除HUS外还进行了CT或MRI检查。CT或MRI扫描未发现HUS未显示的临床显著异常。4例婴儿在初始评估时有轻度发育异常。平均随访时间为13.1个月。随访期间无婴儿出现神经异常。
对于神经系统检查正常且无颅内压升高迹象的巨头畸形婴儿，HUS联合密切的神经学随访对于检测或排除相关颅内病变是可靠的。
