Ventriculomegaly “enlarged ventricles”

Maddalena’s brain looks scary, right? Don’t let this wild brain scan fool you! Maddalena is your typical sassy, loud, and wild toddler. So, what are those huge blobs in her brain? Those are her SUPER enlarged ventricles. A normal brain has very small slits. As you can see, her’s are severely dilated. She has severe ventriculomegaly. She acquired this from a bilateral grade three brain bleed she had after her traumatic birth. Luckily, by the grace of god, her ventriculomegaly did not turn into hydrocephalus. When ventricles are this severely dilated, it is very common to develop hydrocephalus and require a shunt. Prayers work, guys! I’m telling you!!

A lot of people ask me, “What is ventriculomegaly?” I thought the same thing when Maddalena was diagnosed. It’s pretty much a fancy word for “enlarged ventricles in the brain”. If you google it, a lot of websites will tell you it is hydrocephalus. It is not hydrocephalus.

Ventriculomegaly is the medical term used to describe enlargement of the ventricles of the brain. Hydrocephalus is the term used when enlargement of the ventricles has been caused by an increase in the pressure of the cerebro-spinal fluid (CSF) within them. 

Ventriculomegaly can be mild, moderate, or severe. This is determined by the size of the ventricles. CSF is created within the brain and flows from the lateral ventricles into the third ventricle. It then flows through a narrow tube (the cerebral aqueduct) into the fourth ventricle which lies towards the base of the brain. From the fourth ventricle, it flows around the spinal cord and over the surface of the brain before being re-absorbed.

Without signs of increased pressure in the brain (hydrocephalus), ventriculomegaly most likely will not cause any problems. However, it can be linked with hydrocephalus and other problems. Ventriculomegaly can be diagnosed during pregnancy and occurs in around two per cent of all pregnancies. It can also be diagnosed after birth from brain damage or bleeds.

What happens next?

If there are no clinical or radiological (scans) signs of raised pressure or increase in the ventriculomegaly children may not require any further medical intervention like Maddalena.

Children with hydrocephalus will need life-long monitoring to make sure that the pressure on the brain remains normal. If your child does require a shunt keep in mind that shunts can become infected or blocked. Any symptoms of raised pressure such as headaches or vomiting should be monitored immediately. Often a shunt will need to be replaced several times during a person’s lifetime.

Only a small proportion with ventriculomegaly will have any level of developmental delay and this is usually owing to an associated condition rather than the ventriculomegaly.