Abstract
Background The identification of neurosurgical causes of craniomegaly and early institution
of therapy requires for better clinical and functional outcomes.
Aims and Objectives The aim of this study was to evaluate the neurosurgical causes, managements, and
outcomes of craniomegaly in neonate and infants.
Materials and Methods The cases with a history of head enlargement from neonatal period were included in
this study. Their causes, managements, and outcomes were recorded retrospectively
during the period of January 2010 to February 2013, in neurosurgery department at
SGPGIMS Lucknow, and June 2018 to June 2020, at UPUMS, Saifai, Etawah, UP, India.
Results Out of 41 cases, there were 30 (73.14%) cases of hydrocephalus, 4 (9.76%) Dandy-Walker
malformation, 2 (4.88%) subdural collection, 2 (4.88%) arachnoid cyst, 1 (2.44%) craniosynostosis,
and 2 (4.88%) with tubercular meningitis. The age range of our cases was 18 to 178
days and the mean age was 102.54 ± 50.73. Preoperative head circumference range was
39 to 62 cm (mean: 55.27 ± 6.58cm). Majority of the cases (n = 32, 78.05%) were managed with ventriculoperitoneal shunt surgeries. Out of 41 cases,
33(80.49%) had improved outcomes, 7 (17.07%) stabilized, and mortality occurred in
1 (2.44%) case. Postoperatively, there was improvement in the head circumference (range:
39–60 cm and mean: 46.15 ± 5.83 cm) on 6 to 24 months (mean: 17.85 ± 5.18 months)
of follow-up.
Conclusion Hydrocephalus was the commonest neurosurgical cause of head enlargement in neonate
and infants. Shunt surgery was the most common form of management of these cases.
Early detection, institution of therapy, and periodic follow-up program for diagnosing
and treating complications were the key to successful outcomes in these patients.
Keywords
craniomegaly - newborn and infants - etiologies - management and outcomes
