Quantitative follow-up analysis by computed tomographic imaging in neonatal hydrocephalus.

ABSTRACT

We sought a simple and accurate method to monitor neonatal hydrocephalic infants using standard computed tomographic scans. Volume measurements were made by means of pixel counting using a personal computer and a drawing device, as a graphic tablet system, over computed tomographic scans of six infants with neonatal hydrocephalus and four age-matched control infants. The mean value (763.9 +/- 83.3 cm(3)) of the volume of the cranium in the hydrocephalic group was two times higher than that in the age-matched control infants (360.4 +/- 41.4 cm(3)), P < 0.00001. Sequential changes of the ventricular/intracranial volume ratio steadily decreased after cerebrospinal fluid diversion by means of a "two-step procedure" as early in postnatal life as feasible. The mean value (0.67 +/- 0.12) of the lateral ventricle/intracranial volume ratio at birth improved to 12 months of age (0.26 +/- 0.14), P < 0.05. This study has documented, by means of quantitative analysis of serial scans, a statistically significant increase in the neonatal hydrocephalic brain volume after cerebrospinal fluid shunting.