The frequency of seizures and long-term outcome in 68 children with congenital hydrocephalus not associated with myelomeningocele were examined at the Washington University School of Medicine, St. Louis, MO. Mental retardation was a risk factor for the development of seizures and was diagnosed 4 times more frequently in children with seizures (76% compared to 17%). Cortical CNS malformation diagnosed on CT, such as agenesis of the corpus callosum, was another seizure predictive factor (48% v. 17%). The absence of mental retardation, older age and non-paroxysmal EEG at seizure onset, and absence of CNS malformation correlated with seizure remission. Seizures were adequately controlled by anticonvulsants in 42% and medication was successfully discontinued in patients of normal intelligence who had been seizure free for 3 years. [1]

COMMENT. The clinical and neuroradiologic findings in a male infant with congenital hydrocephalus due to intrauterine HTLV-1 infection are reported from the Division of Child Neurology, Institute of Neurological Sciences, Tottori University Faculty of Medicine, Yonago, Japan. A 20 day old male infant was admitted with macrocephaly. The mother developed human T-cell lymphotropic virus type I (HTLV-1) - associated myelopathy shortly after the birth of the infant. The infant’s serum HTLV-1 antibody was elevated, suggesting an intrauterine route of infection. [2]

Factors affecting the prognosis of intrauterine hydrocephalus diagnosed in the third trimester are reviewed from the Department of Neurosurgery, Kobe University, School of Medicine, Japan [3]. Four patients underwent transabdominal or transvaginal cephalocentesis with measurement of intracranial pressure and intrauterine pressure. Another 4 patients had pre- and postnatal CT or MRI measurements of the head performed shortly before and after birth. The results indicated extremely high intracranial pressure in the fetal brain, whereas after birth the macrocephaly was accompanied by a relatively low intracranial pressure. Fetal hydrocephalus is extremely hypertensive and ah impairment of neuronal functional development prenatally can be irreversible. The fetal ventricular amniotic shunt was not appropriate for maintaining the decompressive effect and a more reliable drainage system is required.