Hydrocephalus Flashcards
What is hydrocephalus?
Where there is an increased volume of CSF in the brain leading to an increase in size of the cerebral ventricles.
What are the two different types of hydrocephalus?
- obstructive - to drainage
- communicative / non obstructive - due to a problem with CSF absorption
What can cause an obstructive hydrocephalus?
- tumours
- congenital abnormalities such as aqueductal stenosis
- acute cerebral haemorrhage
What can cause communicative / non obstructive hydrocephalus?
- idiopathic
- following head trauma
- after sub arachnoid haemorrhage
- following meningitis infection
- normal pressure hydrocephalus
How does hydrocephalus present?
Features of raised intracranial pressure
- early morning headache
- nausea and vomiting
- visual changes (with papilloedema on fundoscopy)
How is hydrocephalus managed?
Shunting - normally ventriculoperitoneal.
What are signs of hydrocephalus in babies?
- increased head circumference
- bulging anterior fontanelle
- failure of upwards gaze
What is normal pressure hydrocephalus?
A non obstructive form of hydrocephalus, that is a potentially reversible cause on dementia in older patients.
What is the pathophysiology of normal pressure hydrocephalus?
Impaired absorption of the CSF at the arachnoid villi
What is the triad of symptoms for normal pressure hydrocephalus?
- dementia
- urinary incontinence
- gait abnormalities
What investigations are done for normal pressure hydrocephalus?
- CT / MRI scan of the brain
- lumbar puncture - can also be management to remove some CSF
How is normal pressure hydrocephalus managed?
Shunting - ventriculoperitoneal
- If patient is not fit for surgery then repeated CSF taps can be done
