Article Figures & Data
Figures
- Fig 1.
Case 3. A, Axial FSE T2-weighted image. B, Axial proton density–weighted image. C, Coronal FSE T2-weighted image; 8-month-old girl. Clinical indicatin for examination: macrocrania. Typical small homogeneous subdural collection, similar to those identified in cases 2, 5, and 6. Note diffuse prominence of subarachnoid spaces. Small left frontal vertex subdural collection is identified (arrows), slightly hyperintense to CSF on T2-weighted images (A and C), and moderately hyperintense to CSF on proton density images (B). The collection was isointense to CSF on T1-weighted images and showed no blooming on gradient-echo sequences. Follow-up CT 3 months later showed decrease in prominence of the subarachnoid space, normal ventricles, and no evidence of subdural collection.
- Fig 2.
Case 4. A, Axial CT image. B, Axial FSE T2-weighted image. C, Axial proton density–weighted image. D, Axial gradient recalled-echo image. E, Sagittal T1-weighted image. F, Axial gradient-echo image: 3-month-old boy with macrocrania. Initial CT examination (A) demonstrates moderate sized bilateral subdural collections (arrows), slightly hyperattenuated relative to CSF. MRI examination was performed 14 hours later. Bilateral subdural collections are again identified (white arrows, B, C, and D) hyperintense to CSF on both T2 and proton density–weighted images (B and C). A thin septation is identified on the right (black arrow, B). A layering region of decreased T2 signal is seen on the right (arrowhead, B), which was hyperintense to CSF on T1-weighting (not shown) and blooms on the gradient-echo sequence (arrowhead, D) compatible with blood products. A localized area of increased signal on T1-weighted images in the right parietal vertex subdural collection was noted (arrowhead, E), which was hyperattenuated to brain on CT (not shown) and exhibited blooming on the gradient-echo sequence (arrowhead, F) consistent with additional blood products.
Tables
- Table 1:
Clinical presentation and follow-up in 6 children with enlarged subarachnoid spaces and subdural collections
Patient Age (weeks)/Sex Presentation Enlarged SS? Clinical 1 24/M Increased HC Yes CAT consult, normal Sk survey, characteristic RH. Reported as probable AHT 2 44/M Increased HC Yes No CAT consult 3 35/F Increased HC Yes No CAT consult 4 14/M Increased HC, increased crying Yes CAT consult, normal Sk survey, no RH. Reported as probable AHT 5 33/M Increased HC Yes No CAT consult, no treatment 6 31/M Increased HC Yes No CAT consult, no treatment Note:—RH indicates retinal hemorrhages; Sk survey, conventional radiographic skeletal survey; NS, neurosurgery.
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