Hydrocephalus Flashcards
DEFINTION
HYDROCEPHALUS: increase volume of CSF space in the brain
partcularly the ventricles associated with increase intracranial pression
ICP and associated signs and symptoms
CSF PATHWAY
Production
Choroid plexus (lateral, third and fourth ventricles).
Circulation
Lateral ventricle → third ventricle → fourth ventricle →
central canal of spinal cord → subarachnoid space
Absorption
Arachnoid granulations, choroid plexuses and
glymphatics
CSF function
The mainfunctionsofCSF are
1. To cushion the brain and spinal cord.
2. To provide basic immunological protection to the CNS,
3. To remove metabolic waste
4. To transport neuromodulators andneurotransmitters
VARIANTS
OBSTRUCTIVE ( Non-communicatve) ; Obstructon of CSF fow in the
ventricular system
COMMUNICATIVE:
- Decrease absorpton of CSF from subarachnoid villi and subarachnoid
spaces
- Increase CSF producton( choroid plexus papilloma)
AETIOLOGY
Congenital causes
- Aqueduct stenosis
- Dandy walker syndrome
Acquired causes
- Intraventricular hemorrhage IVH
- Tumours
- Vascular malformaton
- Meningits
- Traumatc Brain Injury
SYMPTOMS AND SIGNS
Antenatal detecton of hydrocephalus
- ANC ultrasonography
Early infancy
- Accelerated head growth
- Bulging fontanel, prominent scalp vein
- sunsetng eye
Later childhood
- Macrocephaly
- Headache
- Lethargy – somnolence
- Visual impairment- papilledema
INVESTIGATIONS
CRANIAL ULTRASOUND in neonates and infants
• CT SCAN for evidence of raised intracranial pressure
• MRI
INVESTIGATIONS
CRANIAL ULTRASOUND in neonates and infants
• CT SCAN for evidence of raised intracranial pressure
• MRI
TREATMENT
NON-SURGICAL / MEDICAL
- DIURETICS
- VENTRICULAR TAP AND LUMBAR PUNCTURE
SURGICAL
- SHUNTS
- ENDOSCOPIC VENTRICULOSTOMY
MONITORING OF SEQUELAE
EPILEPSY
• HEADACHES
• DRAINAGE PROBLEMS
• FINE MOTOR COORDINATION
• CEREBRAL PALSY- SPATICITY
• ENDOCRINE DISORDERS: Precocious puberty
• COGNITIVE DISABILITY
