Congenital Hydrocephalus vs. Microcephalia
Left picture: The diagnosis is a congenital hydrocephalus which was shunted in the neonatal period; the relatively rapid decompression of the intracranial pressure and involution of the ventriculomegaly within 4 months led to a temporary shunt scaphocephaly. Right picture: The diagnosis is a microcephalia which is combined with a clinically seizable microencephaly. The mentioned observations allowed a preliminary differential diagnosis; it was comfirmed by repeated neurological and developmental examinations and neuroradiology. The shunt scaphocephaly is another possible cause of a too long and small skull.
In both pathologies there is a remarkable disproportion between wide face and narrow front. Left picture: The infant makes a bright impression. Right picture: In this case the gastric tube and the bilaterally bent arms with closed fists attract notice; they are not held close to the body.