Hydrocephalus-Related Extreme Macrocephaly Treated by Shunting & Cranial Reduction/Fixation in 1st Week of Life (IMAGE)
Caption
This is a summary of treatment of an infant with hydrocephalus-related extreme macrocephaly. The uppermost image shows the infant with gross macrocephaly before surgery. The sutures are widely split and the infant needs a shoulder roll to support his head. There is evidence of Parinaud syndrome. The next image, moving clockwise, shows the result after placement of a ventriculoperitoneal shunt—a severely collapsed skull with overlapping sutures, dysmorphic appearance, and resolution of the Parinaud syndrome. The bottom right image shows an intraoperative vertex view of the reduction and fixation surgery, in which an absorbable plate was placed across the anterior fontanel. Both surgical procedures were performed during the child’s first week of life. The bottom left image shows the result 2 weeks after surgery, with a newly formed scar and an appearance approaching normalcy. The final image shows the child 14 months after surgery, with an excellent cosmetic outcome.
Credit
Copyright Devon Truong, 2012. Figure is from Manwaring JC, Truong D, Deukmedjian AR, Carey CM, Storrs BB, Rodriguez LF, Tetreault L, Tuite GF. Cranial reduction and fixation with a resorbable plate combined with cerebrospinal fluid shunting for difficult-to-manage macrocephaly related to hydrocephalus. <i>Journal of Neurosurgery: Pediatrics</i>, published online, ahead of print, December 11, 2012; DOI: 10.3171/2012.10.PEDS12340.
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Permission for reuse must be sought from Jo Ann Eliason (<a href="mailto:jaeliason@thejns.org">jaeliason@thejns.org</a> or 434-982-1209).
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