Hydrocephalus

Question 1

What is hydrocephalus?

Answer 1

An abnormal buildup of fluid in the ventricles within the brain

Question 2

What is the difference between communicating and non-communicating hydrocephalus?

Answer 2

In non-communicating hydrocephalus, something obstructs the flow through the ventricular system, in communicating hydrocephalus, a failure to reabsorb CSF occurs from an insult to the arachnoid villi

Question 3

Name a cause of communicating hydrocephalus

Answer 3

• Meningitis
• Subarachnoid haemorrhage

Question 4

What is the commonest cause of non-communicating hydrocephalus?

Answer 4

Aqueductal stenosis

Question 5

What happens in this condition (aqueductal stenosis)?

Answer 5

Cerebral aqueduct, which connects the 3rd and 4th ventricle, is narrowed which decreases the flow of CSF out of the third ventricle, causing CSF to build up in the lateral and third ventricles

Question 6

What is normal pressure hydrocephalus?

Answer 6

Reversible cause of dementia seen in elderly patients that is thought to be secondary to reduced CSF absorption at the arachnoid villi

Question 7

What is the classic triad of features?

Answer 7

• Urinary incontinence
• Dementia and bradyphrenia (slowed thinking and processing information)
• Gait abnormality

Question 8

How is hydrocephalus managed?

Answer 8

Insertion of a ventriculoperitoneal (VP) shunt, to move excess CSF into the abdominal cavity where it is reabsorbed