PTOTSLPCohortAutism research : official journal of the International Society for Autism Research2025

Benign External Hydrocephalus in a Subgroup of Autistic Children Prior to Autism Diagnosis.

Gal Ben-Arie, Ilan Shelef, Gal Meiri and 3 others

PMID 40778474

WHAT IT FOUND

A subgroup of autistic children under two years old had benign external hydrocephalus and enlarged extra-axial cerebrospinal fluid.

This pattern was rare in controls and resolved by age four. These findings suggest a specific early brain development issue in some autistic children.

Key findings

01Benign external hydrocephalus findings were noted in 10 of 83 autistic children, all under two years old.

02Nine of 30 autistic children under 24 months had extra-axial cerebrospinal fluid to total cerebral volume ratios of 0.14 or higher, compared to two of 21 controls.

03Differences in extra-axial cerebrospinal fluid volumes between groups were significant only in the youngest age group and not in older children.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study was retrospective and used clinical MRI samples, so participants may not represent the general autism or typically developing populations. Measurements were based on T2-weighted scans with lower resolution than T1-weighted scans, potentially affecting accuracy. Sample sizes in age subgroups were small, limiting statistical power. Inter-rater reliability for the qualitative diagnosis of benign external hydrocephalus was not assessed. The association with autism severity was weak and inconsistent across age groups.

Declared interests

The authors declared no conflicts of interest. The study was funded by the Israel Academy of Sciences, the Israel Science Foundation, and the Azrieli Foundation.

The easy way to misread this

Do not assume that benign external hydrocephalus in a toddler is a definitive predictor of autism or that it requires treatment. The condition is transient and resolves by age four in most cases, and only a subgroup of autistic children show this pattern.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →