{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T02:28:12Z","timestamp":1794623292167,"version":"4.9.1"},"reference-count":23,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Benign expansion of the subarachnoid spaces (BESS) is a condition seen in macrocephalic infants. BESS is associated with mild developmental delays which tend to resolve within a few years. It is accepted that patients with BESS are at increased risk of spontaneous subdural hematomas (SDHs), although the exact pathophysiology is not well understood. The prevalence of spontaneous SDH in BESS patients is poorly defined, with only a few large single-center series published. In this study the authors aimed to better define BESS prevalence and developmental outcomes through the longitudinal review of a large cohort of BESS patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A large retrospective review was performed at a single institution from 1995 to 2020 for patients 2 years of age or younger with a diagnosis of BESS by neurology or neurosurgery and head circumference &gt; 85th percentile. Demographic data, head circumference, presence of developmental delay, occurrence of SDH, and need for surgery were extracted from patient charts. The subarachnoid space (SAS) size was measured from the available MR images, and the sizes of those who did and did not develop SDH were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Free text search revealed BESS mentioned within the medical records of 1410 of 2.6 million patients. After exclusion criteria, 480 patients remained eligible for the study. Thirty-two percent (n = 154) of patients were diagnosed with developmental delay, most commonly gross motor delay (53%). Gross motor delay resolved in 86% of patients at a mean age of 22.2 months. The prevalence of spontaneous SDH in this BESS population over a period of 25 years was 8.1%. There was no significant association between SAS size and SDH formation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This study represents results for one of the largest cohorts of patients with BESS at a single institution. Gross motor delay was the most common developmental delay diagnosed, and a majority of patients had resolution of their delay. These data support that children with BESS have a higher prevalence of SDH than the general pediatric population, although SAS size was not significantly associated with SDH development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2021.12.peds21436","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T03:23:37Z","timestamp":1644549817000},"page":"536-542","source":"Crossref","is-referenced-by-count":16,"title":["Subdural hematoma prevalence and long-term developmental outcomes in patients with benign expansion of the subarachnoid spaces"],"prefix":"10.3171","volume":"29","author":[{"given":"Katherine G.","family":"Holste","sequence":"first","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare M.","family":"Wieland","sequence":"additional","affiliation":[{"name":"School of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohannad","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemant A.","family":"Parmar","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Saleh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh J. L.","family":"Garton","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cormac O.","family":"Maher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Pediatr Neurol","first-page":"36","article-title":"Epidemiology of benign external hydrocephalus in Norway\u2014a population-based study","volume":"73","author":"Wiig US","year":"2017","unstructured":"Wiig US, Zahl SM, Egge A, Helseth E, Wester K. Epidemiology of benign external hydrocephalus in Norway\u2014a population-based study. Pediatr Neurol. 2017;73:36\u201341.28666559"},{"key":"b2","series-title":"Pediatr Neurol","first-page":"53","article-title":"Clinical, radiological, and demographic details of benign external hydrocephalus: a population-based study","volume":"96","author":"Zahl SM","year":"2019","unstructured":"Zahl SM, Egge A, Helseth E, Wester K. Clinical, radiological, and demographic details of benign external hydrocephalus: a population-based study. Pediatr Neurol. 2019;96:53\u201357.30808532"},{"issue":"5","key":"b3","series-title":"Neuroradiol J","first-page":"410","article-title":"Extra-axial cerebrospinal fluid spaces in children with benign external hydrocephalus: a case-control study","volume":"30","author":"Hussain ZB","year":"2017","unstructured":"Hussain ZB, Hussain AB, Mitchell P. Extra-axial cerebrospinal fluid spaces in children with benign external hydrocephalus: a case-control study. Neuroradiol J. 2017;30(5):410\u2013417.28691570"},{"issue":"2","key":"b4","series-title":"Neuroradiol J","first-page":"245","article-title":"Benign external hydrocephalus in infants. A single centre experience and literature review","volume":"27","author":"Marino MA","year":"2014","unstructured":"Marino MA, Morabito R, Vinci S,  Benign external hydrocephalus in infants. A single centre experience and literature review. Neuroradiol J. 2014;27(2):245\u2013250.24750715"},{"issue":"4","key":"b5","series-title":"Neurosurg Rev","first-page":"417","article-title":"Benign external hydrocephalus: a review, with emphasis on management","volume":"34","author":"Zahl SM","year":"2011","unstructured":"Zahl SM, Egge A, Helseth E, Wester K. Benign external hydrocephalus: a review, with emphasis on management. Neurosurg Rev. 2011;34(4):417\u2013432.21647596"},{"issue":"10","key":"b6","series-title":"Clin Pediatr (Phila)","first-page":"897","article-title":"Subdural hematoma in infants without accidental or nonaccidental injury: benign external hydrocephalus, a risk factor","volume":"50","author":"Ghosh PS","year":"2011","unstructured":"Ghosh PS, Ghosh D. Subdural hematoma in infants without accidental or nonaccidental injury: benign external hydrocephalus, a risk factor. Clin Pediatr (Phila). 2011;50(10):897\u2013903.21576186"},{"issue":"15","key":"b7","series-title":"Am J Med Genet A","first-page":"2023","article-title":"Genetic disorders associated with macrocephaly","volume":"146A","author":"Williams CA","year":"2008","unstructured":"Williams CA, Dagli A, Battaglia A. Genetic disorders associated with macrocephaly. Am J Med Genet A. 2008;146A(15):2023\u20132037.18629877"},{"key":"b8","series-title":"J Pediatr","first-page":"283","article-title":"A retrospective analysis of the utility of head computed tomography and\/or magnetic resonance imaging in the management of benign macrocrania","volume":"182","author":"Haws ME","year":"2017","unstructured":"Haws ME, Linscott L, Thomas C, Orscheln E, Radhakrishnan R, Kline-Fath B. A retrospective analysis of the utility of head computed tomography and\/or magnetic resonance imaging in the management of benign macrocrania. J Pediatr. 2017;182:283\u2013289.e1."},{"issue":"1","key":"b9","series-title":"Pediatr Neurosurg","first-page":"1","article-title":"Long-term health status in benign external hydrocephalus","volume":"47","author":"Yew AY","year":"2011","unstructured":"Yew AY, Maher CO, Muraszko KM, Garton HJ. Long-term health status in benign external hydrocephalus. Pediatr Neurosurg. 2011;47(1):1\u20136.21778677"},{"issue":"1","key":"b10","series-title":"Childs Nerv Syst","first-page":"91","article-title":"Neurocognitive and psychosocial function in children with benign external hydrocephalus (BEH)-a long-term follow-up study","volume":"33","author":"Mikkelsen R","year":"2017","unstructured":"Mikkelsen R, R\u00f8devand LN, Wiig US,  Neurocognitive and psychosocial function in children with benign external hydrocephalus (BEH)-a long-term follow-up study. Childs Nerv Syst. 2017;33(1):91\u201399.27848005"},{"issue":"2","key":"b11","series-title":"Childs Nerv Syst","first-page":"245","article-title":"Quality of life and physician-reported developmental, cognitive, and social problems in children with benign external hydrocephalus-long-term follow-up","volume":"35","author":"Zahl SM","year":"2019","unstructured":"Zahl SM, Egge A, Helseth E, Skarb\u00f8 AB, Wester K. Quality of life and physician-reported developmental, cognitive, and social problems in children with benign external hydrocephalus-long-term follow-up. Childs Nerv Syst. 2019;35(2):245\u2013250.30523438"},{"issue":"4","key":"b12","series-title":"Pediatr Neurosurg","first-page":"188","article-title":"A theoretical model of benign external hydrocephalus that predicts a predisposition towards extra-axial hemorrhage after minor head trauma","volume":"33","author":"Papasian NC","year":"2000","unstructured":"Papasian NC, Frim DM. A theoretical model of benign external hydrocephalus that predicts a predisposition towards extra-axial hemorrhage after minor head trauma. Pediatr Neurosurg. 2000;33(4):188\u2013193.11124635"},{"issue":"10","key":"b13","series-title":"PLoS One","first-page":"e0206340","article-title":"Epidemiology of subdural haemorrhage during infancy: a population-based register study","volume":"13","author":"H\u00f6gberg U","year":"2018","unstructured":"H\u00f6gberg U, Andersson J, Squier W,  Epidemiology of subdural haemorrhage during infancy: a population-based register study. PLoS One. 2018;13(10):e0206340.30379890"},{"issue":"7172","key":"b14","series-title":"BMJ","first-page":"1558","article-title":"Subdural haemorrhages in infants: population based study","volume":"317","author":"Jayawant S","year":"1998","unstructured":"Jayawant S, Rawlinson A, Gibbon F,  Subdural haemorrhages in infants: population based study. BMJ. 1998;317(7172):1558\u20131561.9836654"},{"issue":"9","key":"b15","series-title":"Arch Dis Child","first-page":"952","article-title":"Subdural haematoma and effusion in infancy: an epidemiological study","volume":"90","author":"Hobbs C","year":"2005","unstructured":"Hobbs C, Childs AM, Wynne J, Livingston J, Seal A. Subdural haematoma and effusion in infancy: an epidemiological study. Arch Dis Child. 2005;90(9):952\u2013955.16113132"},{"issue":"1","key":"b16","series-title":"J Neurosurg Pediatr","first-page":"16","article-title":"Macrocephaly in infancy: benign enlargement of the subarachnoid spaces and subdural collections","volume":"18","author":"Tucker J","year":"2016","unstructured":"Tucker J, Choudhary AK, Piatt J. Macrocephaly in infancy: benign enlargement of the subarachnoid spaces and subdural collections. J Neurosurg Pediatr. 2016;18(1):16\u201320.26942270"},{"key":"b17","series-title":"J Biomed Inform","first-page":"290","article-title":"Supporting information retrieval from electronic health records: a report of University of Michigan\u2019s nine-year experience in developing and using the Electronic Medical Record Search Engine (EMERSE)","volume":"55","author":"Hanauer DA","year":"2015","unstructured":"Hanauer DA, Mei Q, Law J, Khanna R, Zheng K. Supporting information retrieval from electronic health records: a report of University of Michigan\u2019s nine-year experience in developing and using the Electronic Medical Record Search Engine (EMERSE). J Biomed Inform. 2015;55:290\u2013300.25979153"},{"issue":"4","key":"b18","series-title":"J Neurosurg Nurs","first-page":"255","article-title":"External obstructive hydrocephalus: a study of clinical and developmental aspects in ten children","volume":"15","author":"Neveling EA","year":"1983","unstructured":"Neveling EA, Truex RC Jr. External obstructive hydrocephalus: a study of clinical and developmental aspects in ten children. J Neurosurg Nurs. 1983;15(4):255\u2013260.6554303"},{"issue":"4)(SS-4","key":"b19","series-title":"MMWR Surveill Summ","first-page":"1","article-title":"Prevalence of autism spectrum disorder among children aged 8 years\u2014Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2016","volume":"69","author":"Maenner MJ","year":"2020","unstructured":"Maenner MJ, Shaw KA, Baio J,  Prevalence of autism spectrum disorder among children aged 8 years\u2014Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2016. MMWR Surveill Summ. 2020;69(4)(SS-4):1\u201312."},{"issue":"11","key":"b20","series-title":"Lancet Psychiatry","first-page":"895","article-title":"Extra-axial cerebrospinal fluid in high-risk and normal-risk children with autism aged 2-4 years: a case-control study","volume":"5","author":"Shen MD","year":"2018","unstructured":"Shen MD, Nordahl CW, Li DD,  Extra-axial cerebrospinal fluid in high-risk and normal-risk children with autism aged 2-4 years: a case-control study. Lancet Psychiatry. 2018;5(11):895\u2013904."},{"issue":"8","key":"b21","series-title":"AJNR Am J Neuroradiol","first-page":"1725","article-title":"Subdural hematomas in infants with benign enlargement of the subarachnoid spaces are not pathognomonic for child abuse","volume":"27","author":"McNeely PD","year":"2006","unstructured":"McNeely PD, Atkinson JD, Saigal G, O\u2019Gorman AM, Farmer JP. Subdural hematomas in infants with benign enlargement of the subarachnoid spaces are not pathognomonic for child abuse. AJNR Am J Neuroradiol. 2006;27(8):1725\u20131728."},{"issue":"1","key":"b22","series-title":"J Neurosurg Pediatr","first-page":"31","article-title":"Evaluations for abuse in young children with subdural hemorrhages: findings based on symptom severity and benign enlargement of the subarachnoid spaces","volume":"21","author":"Hansen JB","year":"2018","unstructured":"Hansen JB, Frazier T, Moffatt M, Zinkus T, Anderst JD. Evaluations for abuse in young children with subdural hemorrhages: findings based on symptom severity and benign enlargement of the subarachnoid spaces. J Neurosurg Pediatr. 2018;21(1):31\u201337.29099352"},{"issue":"2","key":"b23","series-title":"J Neurosurg Pediatr","first-page":"254","article-title":"Enlarged subarachnoid spaces and intracranial hemorrhage in children with accidental head trauma","volume":"19","author":"Fingarson AK","year":"2017","unstructured":"Fingarson AK, Ryan ME, McLone SG, Bregman C, Flaherty EG. Enlarged subarachnoid spaces and intracranial hemorrhage in children with accidental head trauma. J Neurosurg Pediatr. 2017;19(2):254\u2013258.27885942"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/29\/5\/article-p536.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/29\/5\/article-p536.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/29\/5\/article-p536.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T01:56:12Z","timestamp":1794621372000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/29\/5\/article-p536.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,1]]},"references-count":23,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2021.12.peds21436","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,1]]}}}