Hydrocephalus Flashcards
What is hydrocephalus
Accumulation of CSF in ventricles.
With or without ICP
Normal CSF circulation
50ml
CSF formed in
Choroid plexus in lateral ventricles
Travel of CSF
From lateral ventricles to the 3rd ventricles by Monro formen
From 3rd to 4th by sylvius formen
From 4th to subarachanoid space by lnuscka and magandi
To dural space by the villi
Causes
- Absolute
2. Relative
Relative causes?
Due to brain atrophy and no ICP signs
Absolute causes?
- Obstructive
2. Non obstructive
Obstructive causes of absolute?
- Aqueduct of salivi
- Atresia
- Arnold chiri malformation
- Tumor
- Toxoplasmosis
Cause of Aqueduct of salivi?
- Congenital atresia
- Outside obstruction
- Inside obstruction
What is atresia of Aqueduct of salivi?
What is the outside causes?
What the inside causes?
- Is maybe Sex related recessive Or associated Spina befida
- Brain Tumor OR Galen vein obstruction
- Post hemorrhage (premature) OR post Meningitis
Atresia causes?
Rest
Formen monro
Formen of lnuscka and magandi due to cerebellum vermis agensis (Dandy Walker malformation)
What is Arnold chiri malformation?
Downward of brain stem
Non obstructive hydrocephalus causes?
- Defect in absorption
2. Or secretion
Defect in absorption?
- Subarachanoid space adhesion
- Dural space thrombosis
- Leukemia
Defect in secretion?
- Choroid plexus papilloma
2. Choroid plexus congestion
C/o?
- Accelerated enlargement
- Open fontanels
- Saprated sutures
- Scalp vein dilation
- Macwen sign (percussion on head)
- Sunset appearance (deviated eyes)
- Creniotapes
- Short occipit is Arnold chiri malformation Occipit prominent is Dandy Walker malformation
Neurological c/o?
- Vomit
- Squint
- Optic atrophy
- Motor delay
- Pyramidal tract defect in the lower limbs
- Mental retardation
C/o in older child?
4 B
- Brusting headach
- Bulerd vision
- Projectile vomitting
- Bradycardia with hypertension (Cushing response)
Diagnosis?
- Clinical
- X ray skull
A. Before closure of sutures and fontanels
Craniofacial disproportionation with cranium
B. After closure
Beaten silver appearance (wide Sella) - CT MRI diagnostic
- U/S
How to know the type?
A. CT MRI
B. Lumber and ventricles Manometry
C. CSF : xanthochromia
Treatment?
A. Medical by Acetazolamid or Frusmide
If not respond go to shunt
Drew back due electrolytes and PH disturbance
B. Surgical 1. Choroid plexectomy 2. Diathermy for choroid papilloma 3. Extra crenial shunt A. Ventriculoperitoneal B. Ventriculoplural C. Ventreculoartial
Complications of surgery?
- Infections by epidermis
- Nephritis
- Obstruction
- Shorting of the patient
What is macrocephaly?
H. C > 2 SD
Causes of macrocephaly?
A. Crenial
B. Intracranial
What is the crenial causes of macrocephaly?
- Constitutional
- Famillial
- Achondroplasia
- Anemia
- Rickets
What is the intracranial causes of macroocephalus?
- Hydrocephalus
- Hydrancephly (abscent hemisphere)
- Tumor
- Megalencephaly
A. Cretinism
B. Storage disease (mucopolysachridosis)
C. Famillial
