Journal of Ultrasound in Medicine, Vol 20, Issue 3 263-268, Copyright © 2001 by American Institute of Ultrasound in Medicine
Postnatal outcome of fetuses with the prenatal diagnosis of asymmetric hydrocephalus
S. M. Durfee, F. M. Kim and C. B. Benson
Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
We sought to assess the sonographic findings and postnatal outcome in
fetuses with the prenatal diagnosis of asymmetric hydrocephalus. The
sonograms from cases of asymmetric hydrocephalus diagnosed prenatally at
our institution were reviewed. Postnatal outcome was obtained from
maternal, neonatal, and pediatric records. Fourteen fetuses at 17.3 to 38.9
weeks' gestational age on prenatal sonography had a maximum ventricular
measurement of 10.2 to 48.8 mm, with the degree of asymmetry ranging from
2.2 to 27.3 mm. Thirteen of 14 had a normal-sized contralateral ventricle.
Other fetal anomalies identified at sonography included Dandy-Walker
malformation, intraventricular hemorrhage, porencephalic cyst,
hydronephrosis, pleural effusion, and mild dilatation of a renal pelvis.
Eleven fetuses had follow-up prenatal sonography. Among these, ventricular
dilatation resolved in 5, remained the same in 3, increased in 2, and
decreased in 1. Postnatal outcome was normal in 6 cases (43%) and abnormal
in 8 (57%), including 2 cases of in utero intracranial hemorrhage, 2 with
congenital syndromes, 1 with an imperforate foramen of Monro, 1 with
tuberous sclerosis, 1 with developmental delays, and 1 with cerebral palsy.
Asymmetric unilateral hydrocephalus appears to represent an entity
different from bilateral hydrocephalus in that there is less risk of
perinatal death, there are fewer associated anomalies, and the overall
prognosis is better. Outcome may be normal, but fetuses with increasing
unilateral ventriculomegaly and cases associated with other brain
abnormalities tend to have a poor neurologic outcome.
