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Pediatrics
Diagnosis
Brain
Normal Developmental Variation
Enlarged Subarachnoid Spaces
Enlarged Subarachnoid Spaces
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Subarachnoid spaces (SAS)

            • Synonyms

              • Benign SAS enlargement
              • Benign external hydrocephalus
              • Benign extracerebral fluid collections of infancy
              • Benign communicating hydrocephalus
              • Physiologic extraventricular obstructive hydrocephalus
              • Benign macrocephaly of infancy
              • Benign macrocrania of infancy

            • Definitions

              • Enlarged SAS in patient < 1 year of age with macrocrania [head circumference (HC) > 95%]

            IMAGING

            • General Features

              • Radiographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Caré MM: Macrocephaly and subdural collections. Pediatr Radiol. 51(6):891-7, 2021
                                    2. Zahl SM et al: Clinical, radiological, and demographic details of benign external hydrocephalus: a population-based study. Pediatr Neurol. 96:53-7, 2019
                                    3. Hansen JB et al: Evaluations for abuse in young children with subdural hemorrhages: findings based on symptom severity and benign enlargement of the subarachnoid spaces. J Neurosurg Pediatr. 21(1):31-7, 2018
                                    4. Haws ME et al: A retrospective analysis of the utility of head computed tomography and/or magnetic resonance imaging in the management of benign macrocrania. J Pediatr. 182:283-9.e1, 2017
                                    5. Naffaa L et al: The diagnostic yield of ultrasound of the head in healthy infants presenting with the clinical diagnosis of benign macrocrania. Clin Radiol. 72(1):94.e7-11, 2017
                                    6. Tucker J et al: Macrocephaly in infancy: benign enlargement of the subarachnoid spaces and subdural collections. J Neurosurg Pediatr. 1-5, 2016
                                    7. Halevy A et al: Development of infants with idiopathic external hydrocephalus. J Child Neurol. 30(8):1044-7, 2014
                                    8. Marino MA et al: Benign external hydrocephalus in infants. a single centre experience and literature review. Neuroradiol J. 27(2):245-50, 2014
                                    9. Greiner MV et al: Prevalence of subdural collections in children with macrocrania. AJNR Am J Neuroradiol. 34(12):2373-8, 2013
                                    10. Mattei TA et al: Benign extracerebral fluid collection in infancy as a risk factor for the development of de novo intracranial arachnoid cysts. J Neurosurg Pediatr. 12(6):555-64, 2013
                                    11. Schulz M et al: Intracranial pressure measurement in infants presenting with progressive macrocephaly and enlarged subarachnoid spaces. Acta Neurochir Suppl. 114:261-6, 2012
                                    12. Sun M et al: Diffusion tensor imaging findings in young children with benign external hydrocephalus differ from the normal population. Childs Nerv Syst. 28(2):199-208, 2012
                                    13. Bateman GA et al: External hydrocephalus in infants: six cases with MR venogram and flow quantification correlation. Childs Nerv Syst. 27(12):2087-96, 2011
                                    14. Yew AY et al: Long-term health status in benign external hydrocephalus. Pediatr Neurosurg. 47(1):1-6, 2011
                                    15. Zahl SM et al: Benign external hydrocephalus: a review, with emphasis on management. Neurosurg Rev. 34(4):417-32, 2011
                                    16. Fernando S et al: Neuroimaging of nonaccidental head trauma: pitfalls and controversies. Pediatr Radiol. 38(8):827-38, 2008
                                    17. Hellbusch LC: Benign extracerebral fluid collections in infancy: clinical presentation and long-term follow-up. J Neurosurg. 107(2 Suppl):119-25, 2007
                                    18. Paciorkowski AR et al: When is enlargement of the subarachnoid spaces not benign? A genetic perspective. Pediatr Neurol. 37(1):1-7, 2007
                                    19. Muenchberger H et al: Idiopathic macrocephaly in the infant: long-term neurological and neuropsychological outcome. Childs Nerv Syst. 22(10):1242-8, 2006
                                    20. Lam WW et al: Ultrasonographic measurement of subarachnoid space in normal infants and children. Pediatr Neurol. 25(5):380-4, 2001
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Subarachnoid spaces (SAS)

                                              • Synonyms

                                                • Benign SAS enlargement
                                                • Benign external hydrocephalus
                                                • Benign extracerebral fluid collections of infancy
                                                • Benign communicating hydrocephalus
                                                • Physiologic extraventricular obstructive hydrocephalus
                                                • Benign macrocephaly of infancy
                                                • Benign macrocrania of infancy

                                              • Definitions

                                                • Enlarged SAS in patient < 1 year of age with macrocrania [head circumference (HC) > 95%]

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Gross Pathologic & Surgical Features

                                                          • Microscopic Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Caré MM: Macrocephaly and subdural collections. Pediatr Radiol. 51(6):891-7, 2021
                                                                      2. Zahl SM et al: Clinical, radiological, and demographic details of benign external hydrocephalus: a population-based study. Pediatr Neurol. 96:53-7, 2019
                                                                      3. Hansen JB et al: Evaluations for abuse in young children with subdural hemorrhages: findings based on symptom severity and benign enlargement of the subarachnoid spaces. J Neurosurg Pediatr. 21(1):31-7, 2018
                                                                      4. Haws ME et al: A retrospective analysis of the utility of head computed tomography and/or magnetic resonance imaging in the management of benign macrocrania. J Pediatr. 182:283-9.e1, 2017
                                                                      5. Naffaa L et al: The diagnostic yield of ultrasound of the head in healthy infants presenting with the clinical diagnosis of benign macrocrania. Clin Radiol. 72(1):94.e7-11, 2017
                                                                      6. Tucker J et al: Macrocephaly in infancy: benign enlargement of the subarachnoid spaces and subdural collections. J Neurosurg Pediatr. 1-5, 2016
                                                                      7. Halevy A et al: Development of infants with idiopathic external hydrocephalus. J Child Neurol. 30(8):1044-7, 2014
                                                                      8. Marino MA et al: Benign external hydrocephalus in infants. a single centre experience and literature review. Neuroradiol J. 27(2):245-50, 2014
                                                                      9. Greiner MV et al: Prevalence of subdural collections in children with macrocrania. AJNR Am J Neuroradiol. 34(12):2373-8, 2013
                                                                      10. Mattei TA et al: Benign extracerebral fluid collection in infancy as a risk factor for the development of de novo intracranial arachnoid cysts. J Neurosurg Pediatr. 12(6):555-64, 2013
                                                                      11. Schulz M et al: Intracranial pressure measurement in infants presenting with progressive macrocephaly and enlarged subarachnoid spaces. Acta Neurochir Suppl. 114:261-6, 2012
                                                                      12. Sun M et al: Diffusion tensor imaging findings in young children with benign external hydrocephalus differ from the normal population. Childs Nerv Syst. 28(2):199-208, 2012
                                                                      13. Bateman GA et al: External hydrocephalus in infants: six cases with MR venogram and flow quantification correlation. Childs Nerv Syst. 27(12):2087-96, 2011
                                                                      14. Yew AY et al: Long-term health status in benign external hydrocephalus. Pediatr Neurosurg. 47(1):1-6, 2011
                                                                      15. Zahl SM et al: Benign external hydrocephalus: a review, with emphasis on management. Neurosurg Rev. 34(4):417-32, 2011
                                                                      16. Fernando S et al: Neuroimaging of nonaccidental head trauma: pitfalls and controversies. Pediatr Radiol. 38(8):827-38, 2008
                                                                      17. Hellbusch LC: Benign extracerebral fluid collections in infancy: clinical presentation and long-term follow-up. J Neurosurg. 107(2 Suppl):119-25, 2007
                                                                      18. Paciorkowski AR et al: When is enlargement of the subarachnoid spaces not benign? A genetic perspective. Pediatr Neurol. 37(1):1-7, 2007
                                                                      19. Muenchberger H et al: Idiopathic macrocephaly in the infant: long-term neurological and neuropsychological outcome. Childs Nerv Syst. 22(10):1242-8, 2006
                                                                      20. Lam WW et al: Ultrasonographic measurement of subarachnoid space in normal infants and children. Pediatr Neurol. 25(5):380-4, 2001