Hydrocephalus Flashcards
What is Hydrocephalus?
Excessive CSF w/i the cranium
Leads to dilatation of lat ventricles +/- dilation of 3rd/4th ventricles
What are the three main types of hydrocephalus?
Non-communicating (most common)
Communicating
Productive
What causes a non-communicating hydrocephalus?
Blockage of CSF pathway from ventricles to subarachnoid space
What causes a communicating hydrocephalus?
Impairment of CSF reabsorption at arachnoid villi
-usually precipitated by infection(TB meningitis)/SAH
What are the risk factors for hydrocephalus?
Cogenital malformations (stenosis of aqueduct of Sylvius)
Post fossa/brainstem tumours
Post brain insult
What are the common sx/signs of hydrocephalus?
Hedache Vomiting Papilloedema Cognitive impairment Ataxia Bilat pyramidal signs
What investigations are appropriate in suspected hydrocephalus?
CT (ventricle size)
MRI (malformations/tumours)
What is the medical management of hydrocephalus?
Reduce CSF secretion/increase absorption
Used to delay need for surgery
Acetazolamide +/- Furosemide
What is the surgical management of hydrocephalus?
Ventriculo-atrial OR Ventriculo-peritoneal shunting (progressive sx)
Endoscopic third ventriculostomy (if obstructive)
Neurosurgical removal of tumour
What is normal pressure hydrocephalus?
Syndrome of enlarged lateral ventricles, usually in the elderly w/ a classic triad of sx
What are the classic triad of sx in normal pressure hydrocephalus?
Dementia (no signs of cortical atrophy on CT)
Urinary incontinence
Apraxic gait
How can CSF measurements be used to monitor normal pressure hydrocephalus?
Isolated CSF measurements usually normal
Continuous monitoring may show intermittently raised pressure
