Question
She often curls her body. Her neck tilts forward. She holds her breath and strains. It happens in quick succession. If she’s picked up or called out, it stops. This has been going on for a month now. For the past month, she’s been having diarrhea. I suspect it’s due to her stomach. However, the doctor suspects pediatric spasms. The brain CT scan shows: slightly widened subarachnoid space in both frontal and parietal regions.
Answer
The electroencephalogram is normal, and in our daily work, we often encounter parents of infants or toddlers with head CT or MRI scans from other hospitals coming to our department for consultation. Due to the symmetrical widening of the subarachnoid space in the frontal or parietal regions seen on the head CT or MRI scans, they are diagnosed with subdural effusion, brain atrophy, or external hydrocephalus, which causes great concern and fear. When we inquire about the children, they often only have minor scalp injuries or no symptoms at all, and their growth and intellectual development are normal, making it easy to conclude that the children are not suffering from subdural effusion, brain atrophy, or external hydrocephalus. Therefore, we explain in detail to the parents the causes, prognosis, and other relevant situations of “external hydrocephalus.” Most parents express relief and thank us before happily taking their children away. The slight widening of the subarachnoid space (extracerebral space) in the frontal or parietal lobes during infancy can be a physiological phenomenon. The standard for determining the normal range of the subarachnoid space is: the normal width between the surface of the cerebral cortex in the frontal and parietal areas and the inner table of the skull is 0-4mm, and the normal width at the anterior part of the longitudinal fissure is 0-5mm. Some studies suggest