Benign enlargement of the subarachnoid spaces in the infant

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✓ The authors report 18 infants with benign enlargement of the subarachnoid spaces seen at their institution during a 1-year time interval. This condition is characterized by the computerized tomography findings of dilatation of the subarachnoid spaces, normal or slightly enlarged ventricular size, and prominence of the basilar cisterns. Most cases were found in children referred for the evaluation of abnormally increasing head circumference measurements. Although it was not possible to document the development, and, in several cases, improvement of this process, in these patients enlargement of the subarachnoid spaces was a benign diagnosis, not associated with serious neurological dysfunction.

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Address reprint requests to: Laura R. Ment, M.D., Department of Pediatrics, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06510.

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    Computerized tomographic scans showing benign enlargement of the subarachnoid spaces in a 7-month-old male with a history of preterm birth, intraventricular hemorrhage, and rapidly increasing head circumference. Note the dilated subarachnoid spaces in association with relatively normal ventricular size. In addition, the basilar cisterns are enlarged and the cortical sulci are prominent.

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    Computerized tomographic scans demonstrating the improvement in subarachnoid space enlargement in a 9-month-old female referred for evaluation of rapidly enlarging head circumference. Left: Scan at age 4 months shows the typical findings of benign enlargement of the subarachnoid spaces in the infant. Right: Scan at age 9 months reveals a decrease in size of the prominent subarachnoid spaces.

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    Computerized tomography scans comparing the findings in subdural hematoma (upper) with those of benign enlargement of the subarachnoid spaces in the infant (lower). Upper: Scans taken in a 4-month-old baby girl with severe head trauma showing subdural fluid collections, lack of sulcal prominence, and normal basilar cisterns. Lower: Scans taken in a child of similar age referred for evaluation of a rapidly enlarging head. The classical findings of benign enlargement of the subarachnoid spaces are seen.

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