43. Hydrocephalus

Question 1

What is hydrocephalus?

Answer 1

A disturbance of CSF formation or absorption. In other words hydrodynamic CSF disorder.

Question 2

Signs and symptoms

Answer 2

Slowing of mental capacity, cognitive deterioration
Headaches (initially in the morning)
Neck pain (tonsillar herniation)
Vomiting (more in morning)
Blurred vision (papilledema)
Double vision (unilateral/bilateral 6th nerve palsy
Walking problems due to spasticity (predom. lower limbs)
Drowsiness
Incontinence

Question 3

Causes

Answer 3

Congenital: Spina Bifida, Arnold–Chiari malformation, craniosynostosis, Dandy–Walker syndrome, and Vein of Galen malformations.
Acquired: Hemorrhage, meningitis, head trauma, tumors, and cysts.

Question 4

Types and diagnosis

Answer 4

Communicating (non-obstructed), non-communicating (obstructed) and others (NPH)

Physical examination, USG, CT/MRI,

Question 5

Treatment

Answer 5

Medical treat. used to delay surgical intervention: Furosemide, acetazolamide, isosorbide
Surgery; shunts, underlying cause