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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How can an enlarged ventricle be treated as per the attached scans?

Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3239 Questions

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Posted on Thu, 2 Aug 2018 in Brain and Spine
Question: Dear Doctor,
I'd like to ask you about ventricle enlarged issue of my son. He's nearly 10 months old, can roll but still not seat by his own until now. I'm very worry about his status. He was good when my wife in pregnant and when he was born. We just found the ventricle enlargement issue last 3 months ago when we feel he might got some thing wrong beause he ussualy get fever, weak and late in seat and his head circumference also was at high side (90 percentile). I'm providing you the ultrasound scan as below and wonder if I can do anything to get my son better.
- At 7 month, his lateral ventricle: 12.7mm (left), 13.7mm (right) and third ventricle: 11mm. Forth ventricle is not enlarged.
- At 9 month, his lateral ventricle is enlarged up to 15.6mm and 10.4mm for third ventricle, forth ventricle is not enlarged.
- At 9.5 month, his lateral ventricle enlarged up to 16mm and third ventricle: 12.8mm.

Thank you indeed for your review and support
Regards.
doctor
Answered by Dr. Erion Spaho 49 minutes later
Brief Answer:
A brain MRI is necessary.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Both, ventricles enlargement and delay in development, point toward hydrocephalus, a condition characterized by excessive cerebrospinal fluid into brain chambers.

This condition is better evaluated with a brain MRI.

Discuss with your son's Pediatrician about these issues.

If hydrocephalus is confirmed, shunting of cerebrospinal fluid may be necessary.

Hope you found the answer helpful.

Let me know if I can assist you further.

Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Erion Spaho 2 hours later
We also took my son for MRI scan when we first detected his ventricle was enlarged (at 7 months old). There's no adnormality found in his brain, just with a note to follow up with hydrocephalus from the report. I'd like to ask if my son is doing good and his ventricles are not increasing or stable over time then is there any chance for him geting a normal development, esspecilly mental? What is the outlook for my son? Could he go to school later on with other normal child? Thank you for having a look into my issue.
doctor
Answered by Dr. Erion Spaho 12 hours later
Brief Answer:
Good chances for normal development.

Detailed Answer:
Welcome back.

Since the MRI didn't find other brain conditions that may cause hydrocephalus, and ventricle enlargement is moderate and furthermore stable lately, we can say that your son's development may be within normal limits both physically and mentally.

Still following up about ventricles enlargement and possible hydrocephalus is necessary .

Hope this helps.

Kind regards.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Erion Spaho 23 hours later
Dear Doctor,

He's 10 months old now, height is good (90 percentile), weight only 8.2 kg (20 percentile) and head size about of 90 percentile. He can roll and use his hands and legs flexibly however cannot get balance when seating. So should I take him for physical therapy?

If the ventricles get bad, continue increased then how we know to which value it is affected with hydrocephalus that need for surgeon? And a new ETV (endoscopic third ventriculostomy) or shunt traditional method, which one is good?

Thank you very much for supporting.
doctor
Answered by Dr. Erion Spaho 16 hours later
Brief Answer:
Physical therapy may help.

Detailed Answer:
Welcome back.

By now your baby should crawl and stand while holding, so, since there is a problem with the balance, physical therapy may help in achieving the milestones.

Surgery for hydrocephalus indications includes the pathological growth of the head as the principal sign, together with the imaging studies evidence of hypertensive hydrocephalus, symptomatic hydrocephalus, etc.

There are several choices of the shunting, however, ETV is indicated in cases with obstructive hydrocephalus.

A ventriculoperitoneal shunt is the best choice in cases of nonobstructive hydrocephalus.

Hope this helps.

Kind regards.


Above answer was peer-reviewed by : Dr. Kampana
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