Meningitis
JK SCIENCE
REVIEW ARTICLE
Chronic Subdural Fluid Collection in Children
Raj Kumar
Introduction In the pediatric population, chronic subdural fluid collection is group of related condition termed as extracerebral (or extra-axial) fluid collection (1). Chronic subdural fluid collection can present as chronic subdural hematoma or subdural effusion (2). The term subdural hygroma, subdural hydroma, chronic subdural hematoma and beningn extracerebral fluid collection etc have been used very loosely in past to describe the same entity. While the condition of benign external hydrocephalus (benign extra cerebral fluid collection) has been recognized as different entity from above described entities, as it is a self limiting disease of infancy (3). Modern neuroimaging techniques, however have greatly advanced our understanding of these conditions. Surprisingly not much literature exists on the subject, and publications before the advent of modern computed tomography (CT) and magnetic resonance imaging-MRI (1). It is an entity of common interest to pediatricians, physicians and neurosurgeons. The author highlights his experience of subdural fluid collection in small children of less than 2 year age, the role of conservative treatment is emphasized. Pathophysiology and Terminology Excessive fluid within the subarachnoid space occurs with communicating hydrocephalus and in a selflimited condition known by various terms, including benign expansion of the subarachnoid spaces and benign external hydrocephalus (1). According to other theory, the benign external hydrocephalus is thought to occur because of the atersia of arachnoid villi leading to failed CSF absorption and it’s (CSF) consequent accumulation in subarachnoid space (4). Hence this entity is different from other subdural fluid collections i.e. effusion, haematoma or hygroma. Chronic accumulation of fluid within the subdural space may occur as the results of
one or more of three distinct processes. The most
REVIEW ARTICLE
Chronic Subdural Fluid Collection in Children
Raj Kumar
Introduction In the pediatric population, chronic subdural fluid collection is group of related condition termed as extracerebral (or extra-axial) fluid collection (1). Chronic subdural fluid collection can present as chronic subdural hematoma or subdural effusion (2). The term subdural hygroma, subdural hydroma, chronic subdural hematoma and beningn extracerebral fluid collection etc have been used very loosely in past to describe the same entity. While the condition of benign external hydrocephalus (benign extra cerebral fluid collection) has been recognized as different entity from above described entities, as it is a self limiting disease of infancy (3). Modern neuroimaging techniques, however have greatly advanced our understanding of these conditions. Surprisingly not much literature exists on the subject, and publications before the advent of modern computed tomography (CT) and magnetic resonance imaging-MRI (1). It is an entity of common interest to pediatricians, physicians and neurosurgeons. The author highlights his experience of subdural fluid collection in small children of less than 2 year age, the role of conservative treatment is emphasized. Pathophysiology and Terminology Excessive fluid within the subarachnoid space occurs with communicating hydrocephalus and in a selflimited condition known by various terms, including benign expansion of the subarachnoid spaces and benign external hydrocephalus (1). According to other theory, the benign external hydrocephalus is thought to occur because of the atersia of arachnoid villi leading to failed CSF absorption and it’s (CSF) consequent accumulation in subarachnoid space (4). Hence this entity is different from other subdural fluid collections i.e. effusion, haematoma or hygroma. Chronic accumulation of fluid within the subdural space may occur as the results of
one or more of three distinct processes. The most
References: ≤ 10 30-35 20-25 10-15 ≤ 10 ≤ 10 NR Variable Standard Standard Standard NR ED = Editorial RA = Review Article; OA = Original Article; SC = Short Research Communication; CR = Case Report; DR = Drug Review Vol. 7 No. 1, January-March 2005