Hydrocephalus

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Hydrocephalus

  1. 1. Hydrocephalus Dr Ajay Agade
  2. 2. What is Hydrocephalus? The term hydrocephalus is derived from the Greek words “hydro” meaning water and “cephalus” meaning head. As the name implies, it is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Its not a disease but a diverse group of condition .
  3. 3. Types of hydrocephalus1. Obstructive Cong. Aqueductal steosis Leison in ventricular system2. Non obstructive Impaired absorption Over production3.Unspecified Normal pressure Hydrocephalus ex vacuo X linked cong.
  4. 4. Other types of Hydrocephalus* Ex-vacuo occurs when there is damage to the braincaused by stroke of a traumatic injury.* Normal pressure hydrocephalus commonly occurs in theelderly, due to aging.* word about hydrencephaly
  5. 5. Causes of HydrocephalusHydrocephalus is the result when the flow of CSF isdisrupted when your body doesnt absorb it properly.CSF provides a number of importantfunctions, including acting as a cushion for protectionand transporting nutrients to the brain. There are twomain causes; obstructive and non-obstructive.
  6. 6. Obstructive (non-communicating) This type of hydrocephalus results froman obstruction within the ventricular systemof the brain that prevents CSF from flowingor “communicating” within the brain.
  7. 7. Non-obstructive (communicating)This type results fromproblems with theproduction orabsorption of CSF.The most common iscaused by bleedinginto thesubarachnoid spacein the brain.
  8. 8. Early symptoms (infants)* Enlargement of the head* Bulging fontanels* Sutures are separated* Vomiting
  9. 9. Late symptomsa. Decreased mental functionb. Delayed movementsc. Difficulty feedingd. Excessive sleepinesse. Brief, shrill, high-pitched cryf. Slow growth (0-5 years)g. Headacheh. Visual Changesi. Personality Changesj. Herniation Syndrome
  10. 10. Diagnosis Detailed History & Clinical examination1. Tapping with the fingertips on the skull may show abnormal sounds associated with thinning and separation of skull bones.2. Tran illumination.3. Scalp veins may appear dilated.4. Eyes are depressed.
  11. 11. Laboratory workup1. ABG2. Sepsis screen3. Skull X-rays4. Head CT scan5. Lumbar punctures Invasive6. ICP monitoring Non-Invasive
  12. 12. TreatmentAim1. The main goal is to minimize or prevent brain damage by improving CSF flow.2. Surgical interventions are the primary treatment, including direct removal of the obstruction, if possible. A surgical shunt within the brain may allow CSF to bypass the obstructed area, if obstruction cannot be removed. Basic therapy1. Maintain ABC2. Head position3. Temperature & B.P. Control4. Seizure Control5. Fluid6. Steroid & lidocaine7. Osmotherapy8. Ext. Stimulus
  13. 13. Advance Therapy1. Barbiturate coma2. Moderate hypothermia3. Decomressive surgery4. Neuromascular blocking shunt
  14. 14. The End
  15. 15. References AD Tewari, IAP textbook of pediatrics 4th edition 2009 Robert H.A. Nelsons textbook of pediatrics 18th edition 2008 www.health.yahoo.com www.mayoclinic.com

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