hydropcephalus

Question 1

what is hydrocephalus?

Answer 1

Hydrocephalus is an abnormal build-up of cerebrospinal fluid(CSF) within and around the brain, which can due to excess fluid production, obstruction to its flow, and inadequate absorption[1] If left untreated, the excess fluid can cause increase the pressure put on the skull and brain, which can be damaging[2].

Question 2

causes?

Answer 2

The etiology of hydrocephalus can be congenital or acquired. Hydrocephalus due to any obvious external cause is termed as congenital hydrocephalus whereas hydrocephalus secondary to any condition such as hemorrhage is known as acquired hydrocephalus.

Question 3

most common cause ?

Answer 3

The most common cause of acquired hydrocephalus in infants is hemorrhage due to prematurity

In addition to this, the other causes include neoplasm, an infection most often bacterial meningitis, intrauterine infections with enterovirus, lymphocytic choriomeningitis, toxoplasmosis, and CMV.

Question 4

Classification

Answer 4

communicating hydrocephalus and non communicating hydrocephalus.

Question 5

Communicating hydrocephalus is further divided into?

Answer 5

obstructive and non obstructive types.

Question 6

what is Communicating hydrocephalus?

Answer 6

results when there is impedance of cerebrospinal fluid after it exits the ventricles. Communicating hydrocephalus can be obstructive in nature where there is obstruction at some point between basal cisternae and arachnoid granulations. This obstruction can be due to conditions like subarachnoid hemorrhage , meningitis , congenital or acquired pathologies

Non obstructive communicating hydrocephalus includes normal pressure hydrocephalus which can be idiopathic or secondary following trauma

Question 7

Non communicating hydrocephalus?

Answer 7

occurs when there is intra ventricular obstruction of CSF flow , therefore non communicating hydrocephalus is always of obstructive type. This obstruction in the CSF flow can be due to conditions such as TORCH INFECTIONS[1] or congenital anomalies, The sites of obstruction includes Foramen of Munro and cerebral aqueduct

Question 8

Pathophysiology - Change in CSF dynamics.

Answer 8

With the development of hydrocephalus, there is an alteration in CSF dynamics. The CSF exchange between the lateral ventricles and the third ventricles is compromised. With the development of hydrocephalus the Foramen of Munro undergoes dilation. Both the lateral ventricle and the third ventricle becomes monoventricule , however the cerebral aqueduct retains its function. Also there is exaggerated motion of CSF through cerebral aqueduct. In addition to this CSF pulsatility( i.e with every heart beat the arterial blood volume increases briefly and venous blood and CSF are pushed out of the cranium which leads to the pulsatile flow of CSF)is also disturbed. These changes lead to compromise in the unidirectional flow of CSF from the site of production to the site of absorption

Question 9

Clinical features

Answer 9

Clinical features of hydrocephalus before the closure of the cranial sutures (<2 years of age ) include macrocephaly, increasing head circumference of the head , sunsetting sign, distend scalp veins , developmental delay, poor feeding and regression.
After the closure of cranial sutures , the acute presentation includes, headache, vomiting, drowsines , papilleodem,a and coma in extreme cases.
Chronic presentation and clinical features of normal pressure hydrocephalus include incontinence cognitive impairments and gait disturbances