Diagnosis and Treatment of Fetal Hydrocephalus

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  • 胎児期水頭症の診断と治療

Abstract

<p>  Diagnosis of fetal hydrocephalus is challenging, and ventriculomegaly unassociated with increased intracranial pressure is often misdiagnosed as fetal hydrocephalus. Several conditions including chromosomal abnormalities and multiple anomaly syndromes may cause ventricular dilatation, and diagnosis and prediction of prognosis based solely on imaging studies is difficult.</p><p>  Diagnosis of fetal ventriculomegaly is defined based on the atrial width (AW). AW does not exceed 10 mm from week 15 to 40 of gestation; therefore, an AW of ≥10 mm is defined as ventriculomegaly. In addition to ventricular dilatation, disappearance of the subarachnoid space or enlargement of the head circumference leads to a high index of clinical suspicion for hydrocephalus. Despite technological advances in fetal diagnostics, accurate diagnosis remains limited, and extensive knowledge regarding potential underlying causes is warranted.</p><p>  Between 2012 and 2020, 104 fetuses diagnosed with ventriculomegaly at our hospital underwent fetal magnetic resonance imaging at a mean gestational age of 27 weeks. We detected hydrocephalus in the narrow sense in 47 fetuses, and 57 fetuses had ventricular enlargement without hydrocephalus. The underlying etiology consisted of 19 diseases, and 20 cases were undiagnosed.</p><p>  In this report, we present a brief overview of intrauterine myelomeningocele treatment and pre-implantation diagnosis of X-linked hydrocephalus.</p>

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