الفهرس 
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Abstract
Hydrocephalus is the most common neurological pathology in the pediatric age group that results from a disturbed balance between the production and absorption of the cerebrospinal fluid (CSF) causing abnormal dilation of the intracranial ventricular system.
This study was carried out to identify and distinguish the role of dynamic MRI study in the evaluation of the type and cause of hydrocephalus in pediatric patients for proper management. The study was included 50 hydrocephalic pediatric patients ranging from 10 days up to 16 years, 29 were females and 21 were males referred to the Pediatric Neurology Unit at El-Shatby Hospital in the period between January 2018 and October 2019 presented with varies neurological manifestations.
MRI studies were done for all cases including conventional MRI study (Axial, coronal T2 weighted image, axial and sagittal T1WI, axial FLAIR and SWI) and dynamic MRI study (3D-DRIVE and PC-MRI).
Hydrocephalus was classified into the obstructive type and non-obstructive type. A) Obstructive hydrocephalus including 44 patients (88%) further was classified as intraventricular hydrocephalus which includes 35 patients and extraventricular type including nine patients and B) non-obstructive hydrocephalus including 6 patients (12%).
Intraventricular hydrocephalus categories according to the level of obstruction a) at the level of the aqueduct of Sylvius were 17 patients (38.6%) including totally occluded aqueduct (10 patients) and aqueductal stenosis (seven patients), 15 patients of which showed arrested hydrocephalus and only two were active type, b) at the foramen of Monro level involved 3 patients (6.8%) including suprasellar arachnoid cyst, midline colloid cyst and post-hemorrhagic, two patients showed arrested hydrocephalus and only one showed active type, c) at the level of 4th ventricle including 15 patients (34%) that further categorized into i) posterior fossa malformations (nine patients); a) cystic malformations; classical Dandy Walker (one patient), persistent Blake’s pouch cyst (only one patient), retrocerebellar arachnoid cysts (two patients) and b) non-cystic malformations; Chiari I malformation (two patients) and Chiari II malformation (three patients), all posterior fossa malformations patients showed arrested hydrocephalus and ii) acquired entrapped 4th ventricle (six patients) including post-infection (five patients) and post-hemorrhagic (only one patient), five patients were active hydrocephalus and only one patient was arrested.
Extraventricular hydrocephalus was shown in 9 patients (20.5%) including post-infection (four patients) and post-hemorrhagic (five patients). Four patients were active and the remaining five patients have arrested hydrocephalus.
Non- obstructive hydrocephalus including 6 patients (12%) classified a) benign external hydrocephalus (two patients), post-hemorrhagic (three patients), post-infection (only one patient).