Benign Infantile Hydrocephalus: In Which Child, When Should We Think, What Should We Do?

Abstract

Benign infantile hydrocephalus, one of the most common causes of macrocephaly, is a self-limiting clinical condition thought to be caused by the immaturity of the arachnoid villi responsible for the absorption of cerebrospinal fluid. In cases with the findings of an increase in head circumference and large anterior fontanel, the absorption of cerebrospinal fluid returns to normal with the maturation of the arachnoid villi over time and the findings begin to regress at around 18 to 24 months of age. The disease resolves spontaneously without leaving any neurological sequelae. Therefore, although the increase in head circumference causes anxiety in the physicians and parents, further examinations should be performed only in children whose mental motor development is delayed or whose enlargement in the subarachnoid space does not improve by the age of 2 years. Our aim in presenting this case report is to emphasize that if benign infantile hydrocephalus is considered in children with macrocephaly and if the neurological examination is normal and there is no neurodevelopmental retardation, close follow-up of the child will be sufficient and further investigations are not necessary. Our case was a patient whose head circumference was within normal limits at birth and in the first three months, and increased rapidly during follow-up to >97 percentile. As a result of the examinations, it was evaluated as benign infantile hydrocephalus.