There is a difference between these two conditions-albeit not huge- can you discuss what this difference is? Describe the development of ventriculomegaly and/or hydronephrosis and explain the criteria for diagnosing each.
Discussion Board Week 5.............
Ventriculomegaly vs Hydrocephaly
Re: Ventriculomegaly vs Hydrocephaly
Ventriculomegaly is when the ventricles are enlarged. specifically when the lateral ventricles exceed 10mm. Hydrocephalus is when ventriculomegaly causes pressure changes with causes the calvarium to enlarge. We will notice this sonographically when the BPD/HC is greater than gestational age and the ventricles are dilated.
From sonoworld/thefetus.
there is an x linked form of congenital hydrocephalus. Those effected tend to have very severe hydrocephalus, spasticity, sever mental retardation and adducted thumbs.
The example I found was of a family with no family prevelance. The male fetus was found to have mild ventriculomegaly from a congenital stenosis of the aqueduct of silvius. There is a possiblity of adding shunt to the stenosed aqueduct to relieve the pressure in the head and allow CSF to flow. Notice the size of the lateral ventricles and dilation of the third ventricle from the 23 week scan.
Flexed thumb
abnormal branching of the pericallosal artery and partial agenesis of the corpus callosum.
Re: Ventriculomegaly vs Hydrocephaly
Hi Heatha,
So I'm pretty sure you answered this in class, but you HAVE to have Ventriculomegaly in order to have Hydrocephalus, correct?
Also thanks for the pictures, I could imagine getting a flexed thumb image may be overlooked as "normal". I scanned an OB today and baby's hand was in a rockstar pose. I thought it was normal, kinda funny actually, but makes me wonder if there is an anomaly associated with it or if I missed something like an amniotic band forcing those 3 fingers to be flexed down..... or it's just normal and I'm thinking of all the worst possibilities because all this OB pathology is so fresh in my mind.
Re: Ventriculomegaly vs Hydrocephaly
Yes, the cause of hydrocephaly is ventriculomegaly as far as I understand. The article I linked below goes into how most cases are caused by aquaductal stenosis, chiari, or dandy walker malformation, however all of these present as ventriculomegaly as well.
As far as the hand I love finding the babies making gestures. We find them giving a thumbs up often. I try and get a printout for mom when that happens. What week are we learning skeletal abnormalites? I bet we will know more after that.
Re: Ventriculomegaly vs Hydrocephaly
Yes, typically you have to have ventriculomegaly as that is simply >10mm vent size---and we usually believe there to be hydro after >15mm. Because the ventricular system is like plumbing....everything downstream typically begins to enlarge when there is an obstruction.
Re: Ventriculomegaly vs Hydrocephaly
Hi Heather. Just replying so you know That I read your post. :P
Is the severe mental retardation because of the congenitaly hydrocephalus or from an associated aneuploidy?
I like how you included the closed hand picture. Did they list any other pathology besides the stenosed area?
Re: Ventriculomegaly vs Hydrocephaly
ventriculomegaly is the enlargement of the ventricle structures. To define enlargement is that the ventricles are exceeding over 10cm
hydrocephaly is the accumulation of csf fluid in the ventricles.
the problem here is that both hydrocephalus and ventriculomegaly appear the same via ultrasound. How can we differentiate these two???
VENTRICULOMEGALY
- dilation of ventricles ( measuring more than 10mm)
- dilation caused due to possible obstruction
- HEAD IS NOT ENLARGED WITH VENTRICULOMEGALY!!
- sono sign the " dangling choroid sign"
HYDROCEPHALUS
- dilation of ventricles due to the excessive accumulation of the CSF fluid
- ENLARGED HEAD measuring 2 standard deviations of the bpd/hc
Re: Ventriculomegaly vs Hydrocephaly
I love using TheFetus.net. You guys can search any pathology and the results are all cases of what your'e looking for, sometimes they even include cine clips! I looked up ventriculomegaly and hydrocephalus because if I can see some slight difference between images of the two, I think it will help me later on in my career.
I've attatched some key points I found from the sources I used and included a couple pictures of both of these highly similar pathologies.
PATHOLOGY: Fetuses with isolated ventriculomegaly diagnosed in utero at our institution were usually found at birth to have either aqueductal stenosis or communicating ventriculomegaly.
OB MANAGEMENT (of hydrocephalus): Intrauterine treatment consisting of the implantation of a ventriculoamniotic shunt for the relief of intracranial pressure during gestation has been attempted.
I found this statement interesting, especially with Michelle sharing her story of ventriculomegaly with her youngest; "congenital infections associated with hydrocephalus (i.e., toxoplasmosis, cytomegalovirus, rubella) is indicated".
https://sonoworld.com/TheFetus/page.aspx?id=141
Ventriculomegaly.....You would have to take BPD measurement to see if calvarium was enlarged, but from eyeing this image it appears to be wnl and oval shaped.
Hydrocephalus, here it is more apparent that the calvarium is enlarged due to the increased amount of cerebro-spinal fluid in the lateral (& 3rd) ventricles.