СРАВНИТЕЛЬНЫЙ АНАЛИЗ КЛИНИЧЕСКИХ, НЕЙРОСОНОГРАФИЧЕСКИХ И ТОМОГРАФИЧЕСКИХ ДАННЫХ ПРИ ЛИКВОРОДИНАМИЧЕСКИХ РАССТРОЙСТВАХ У ДЕТЕЙ: ДИАГНОСТИЧЕСКИЕ КРИТЕРИИ, НЕЙРОВИЗУАЛИЗАЦИОННЫЕ МАРКЕРЫ И ПРОГНОСТИЧЕСКИЕ ПОДХОДЫ

Abstract

Background. Cerebrospinal fluid dynamic disorders in children represent a heterogeneous group of conditions involving altered cerebrospinal fluid circulation, distribution, and absorption. Hydrocephalus is particularly important because progressive ventricular enlargement may be associated with changes in intracranial compliance, cerebral perfusion, and neurodevelopment. Diagnosis is complicated by age-dependent clinical manifestations, limited specificity of isolated imaging markers, and the need to distinguish active hydrocephalus from ventricular enlargement secondary to cerebral tissue loss.

Objective. To compare the diagnostic contribution of clinical manifestations, neurosonographic measurements, computed tomography, and magnetic resonance imaging in pediatric cerebrospinal fluid dynamic disorders and to develop a structured multimodal diagnostic framework.

Materials and Methods. A narrative analytical review of clinical studies, systematic reviews, and international recommendations was conducted. The analysis focused on pediatric hydrocephalus, posthemorrhagic ventricular dilatation, shunt malfunction, quantitative cranial ultrasonography, conventional and rapid magnetic resonance imaging, computed tomography, and phase-contrast cerebrospinal fluid flow imaging.

Results. The clinical applications and limitations of major diagnostic approaches were systematically evaluated. An original conceptual framework, PED-CSF-DIAG, was developed to integrate clinical stability, longitudinal ventricular measurements, anatomical obstruction, secondary brain injury, and treatment-related factors.

Conclusion. Accurate diagnosis of pediatric cerebrospinal fluid dynamic disorders requires age-adapted integration of neurological examination, quantitative neurosonography, and targeted tomographic investigations. Longitudinal changes in ventricular size should be interpreted in conjunction with clinical manifestations, anatomical findings, and previous imaging.