Hydrocephalus

Hydrocephalus

                                            Summary:

-excessive accumulation of CSF in the brain resulting into ventricular widening

-Types:

congenital and  acquired;

communicating and non- communicating (obstructive) hydrocephalus. One of he common cause of hydrocephalus is aqueductal stenosis(non-communicating)

hydrocephalus ex-vacuo and normal pressure hydrocephalus

-1 in every 500 children

-the infant skull can expand to accommodate the buildup of CSF so can tolerate hydrocephalus better than adults

-symptoms: increase in head circumference( in children), vomiting,sleepiness, irritability, downward deviation of eyes( sunsetting), seizures ,papilledema, double vision ,urinary incontinence, lethargy, drowsiness, memory loss.

-symptoms of normal pressure hydrocephalus: gait problem, urinary incontinence and dementia.( very confused with Alzheimer’s disease, parkinson’s disease and creutzfeldt-jakob disease)

-CT or MRI for diagnosis

-Treatment: surgical insertion of a shunt system

    In few patients( third ventriculostomy)

-Complication of a shunt system:

Mechanical failure, infections, obstructions, need to lengthen or replace the catheter,

overdraining: causes ventricles to collapse,subdural hematoma, slit ventricle syndrome

Underdraining: symtoms persists

Prognosis:

Fully recovered in some patients whereas reoccur in other patients. Complicated by other health conditions