Hydrocephalus

Question 1

Define hydrocephalus

Answer 1

pathological conditions of inc CSF in brain ventricular system -> raised ICP -> can damage brain parenchyma with severe neurological consequences

Question 2

What is the epidemiology of hydrocephalus?

Answer 2

Common in infants - congential malfomration or haemorrhage
1/2 per 1,000 liver births

Question 3

What are the two main types of hydrocephalus?

Answer 3

Non-communicative (obstructive) - blockage of CSF flow such as stenosis, tumour, IV haemorrhage

Communicative - CSF is not adequately reabsorbed due to damage to the arachnoid villi

Question 4

What are some potential causes of communicating hydrocephalus?

Answer 4

Meningitis
Subarchnoid haemorrhage

Question 5

What is the presentation of hydrocephalus?

Answer 5

Enlarged head circumference - noticeable upon inspection or tracking growth
Bulging of anterior fontanelle
Distention of scalp veins
Sunsetting of eyes - late sign - upward gaze is limited due to raised ICP.

Question 6

What are the key differentials for hydrocephalus?

Answer 6

Benign enlargement of subarachnoid spaces - macrocapehlay no sunsetting
Subdural haematoma -> history of trauma
brain tumour -> rare, vomiting, lethargy or behavioural changes

Question 7

What are the key investigations for hydrocephalus?

Answer 7

Cranial ulstraound through anterior fontanelle -> first few months
MRI or CT of brain - for ventricula size and underlying cause

Question 8

What is the management of hydrocephalus?

Answer 8

Surgical - ventriculoperiteonal shunt
Counsel cargivers about complications -> blocked or infected require medical attention

Question 9

What are the potential long term neurological deficits from hydrocephalus?

Answer 9

Speech, learning or memory problems
Vision loss
Epilepsy