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"Growing" Cerebellum in an Infant After Shunt Insertion.
MedLine Citation:
PMID:  25468532     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Supratentorial cortical mantle growth after shunt surgery in infants with posthemorrhagic hydrocephalus is common. However, cerebellar growth and Chiari are rare.
PATIENT DESCRIPTION: We describe a term newborn with an intraventricular hemorrhage and posthemorrhagic hydrocephalus who underwent endoscopic third ventriculostomy followed by shunt placement at age 4 months.
RESULTS: After shunt placement, her head circumference growth rate rapidly decreased from the ninety-seventh percentile to the third percentile. Six months after a shunt placement, cerebellar disproportional growth was noticed. Five years after surgery, her cerebellar volume had increased by 300% whereas the cerebral hemispheres volume by 150%, and Chiari 1 appeared. She manifested early hemiparetic cerebral palsy, but, did not develop clinical evidence of increased intracranial pressure or brainstem abnormalities.
CONCLUSION: This term newborn exhibited apparent cerebellar "growth" and posterior fossa crowding after shunt surgery for posthemorrhagic hydrocephalus. Our patient's findings may have resulted from shunt-related alterations in pressure dynamics, leading to decreased head growth rate with a relatively smaller posterior fossa, in face of a normal brain growth. The timing of intraventricular hemorrhage at term, beyond the vulnerable period of cerebellar development, may have been a contributing factor to the craniocerebellar disproportion and posterior fossa crowding cerebellar development may have been relatively spared and was a contributing factor to the craniocerebellar disproportion and posterior fossa crowding.
Haggai Benvenisti; Haim Bassan; Shelly Shiran; Sholmi Constantini; Jonathan Roth
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-13
Journal Detail:
Title:  Pediatric neurology     Volume:  -     ISSN:  1873-5150     ISO Abbreviation:  Pediatr. Neurol.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-12-3     Completed Date:  -     Revised Date:  2014-12-4    
Medline Journal Info:
Nlm Unique ID:  8508183     Medline TA:  Pediatr Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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