Hydrocephalus

Question 1

What is hydrocephalus

Answer 1

A condition where there is excessive volume of CSF within the cranium

Question 2

What are some causes of hydrocephalus

Answer 2

Congenital - Arnold-Chiari malformation, aqueduct stenosis, Dandy Walker

Non-communicating hydrocephalus - tumours in posterior fossa or brainstem, subarachnoid haemorrhage, meningitis, head injury, third ventricle cyst

Normal pressure hydrocephalus

Question 3

What are the signs and symptoms of obstructive hydrocephalus

Answer 3

Signs of raised ICP - headache, nausea, vomiting, papilloedema, drowsiness, coma, ataxia

Question 4

What is Normal pressure hydrocephalus

Answer 4

Dilatations of the cerebral ventricles without signs of raised ICP

Question 5

Who is most likely to get normal pressure hydrocephalus

Answer 5

Elderly

Question 6

What symptoms are present in normal pressure hydrocephalus

Answer 6

Triad - Dementia, Urinary incontinence, Gait apraxia

Question 7

How do you treat hydrocephalus

Answer 7

Ventriculoatrial shunt
Ventirucloperitoneal shunt
3rd ventriculostomy

Question 8

How would you diagnose normal pressure hydrocephalus

Answer 8

Clinically
Lumbar puncture - remove up to 50ml CSF resulting in improved symptoms
CT head - ventricular dilatation

Question 9

In obstructive hydrocephalus, where is the blockage most likely to occur

Answer 9

At the outlets of the fourth ventricle

May also occur at the level of the cerebral aqueduct