Volume 27, Issue 134, April 2023

An unusual case of cerebellar herniation in a neonate secondary to communicating hydrocephalus

Iyer Lavanya Ramakrishnan^1♦, Mahaveer Lakra², Bhavana Lakhkar³, Nishant Raj⁴, Shikha Kakkat¹, Anirudh Komareddy¹

¹Post Graduate Student, Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Meghe, Wardha, Maharashtra, India
²Assistant Professor, Department of Neonatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Meghe, Wardha, Maharashtra, India
³Professor and HOD, Department of Neonatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Meghe, Wardha, Maharashtra, India
⁴Post Graduate Student, Department of Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi Meghe, Wardha, Maharashtra, India

^♦Corresponding author
Post Graduate Student, Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Meghe, Wardha, Maharashtra, India

ABSTRACT

The incidence of sepsis causing meningitis is a common finding seen in neonates. Meningitis, if not diagnosed early and intervened on time with adequate amount and duration of antibiotics can lead to catastrophic complications in the neonate, mainly leading to a communication hydrocephalus with mantle thinning, further leading to severe neuro morbidity. This case reports a neonate presenting on the 5th day of life with repeated episodes of vomiting but was treated symptomatically. The patient was further referred to us with incessant vomiting and depressed activity on day of life 24. The patient further had failure to thrive with significant weight loss since birth. General physical examination and routine examination revealed a case of communicating hydrocephalus secondary to sepsis causing meningitis which was left untreated. On further evaluation, neuroimaging revealed cerebellar tonsillar herniation. It is a common phenomenon to expect raised intracranial (ICP) leading to herniation in patients with a closed fontanelle. Here, we report a case of gross, communicating hydrocephalus causing cerebellar herniation in a paraneonate, which is not a well-known phenomenon in literature.

Keywords: Neonate, Partially Treated Meningitis, Hydrocephalus, Cerebellar Herniation, Subgaleal Shunt, Ventricular dilatation

Medical Science, 2023, 27, e180ms2866

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DOI: https://doi.org/10.54905/disssi/v27i134/e180ms2866

Published: 03 April 2023