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. Types of hydrocephalus
1. Obstructive Cong. Aqueductal steosis
Leison in ventricular system
2. Non obstructive Impaired absorption
Over production
3.Unspecified Normal pressure
Hydrocephalus ex vacuo
X linked cong.
4. Other types of
Hydrocephalus
* Ex-vacuo occurs when there is damage to the brain
caused by stroke of a traumatic injury.
* Normal pressure hydrocephalus commonly occurs in the
elderly, due to aging.
* word about hydrencephaly
5. Causes of Hydrocephalus
Hydrocephalus is the result when the flow of CSF is
disrupted when your body doesn't absorb it properly.
CSF provides a number of important
functions, including acting as a cushion for protection
and transporting nutrients to the brain. There are two
main causes; obstructive and non-obstructive.
6. Obstructive (non-communicating)
This type of hydrocephalus results from
an obstruction within the ventricular system
of the brain that prevents CSF from flowing
or “communicating” within the brain.
7.
8. Non-obstructive
(communicating)
This type results from
problems with the
production or
absorption of CSF.
The most common is
caused by bleeding
into the
subarachnoid space
in the brain.
9. Early symptoms (infants)
* Enlargement of the head
* Bulging fontanels
* Sutures are separated
* Vomiting
10. Late symptoms
a. Decreased mental function
b. Delayed movements
c. Difficulty feeding
d. Excessive sleepiness
e. Brief, shrill, high-pitched cry
f. Slow growth (0-5 years)
g. Headache
h. Visual Changes
i. Personality Changes
j. Herniation Syndrome
11. Diagnosis
Detailed History & Clinical examination
1. 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.
14. Treatment
Aim
1. 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 therapy
1. Maintain ABC
2. Head position
3. Temperature & B.P. Control
4. Seizure Control
5. Fluid
6. Steroid & lidocaine
7. Osmotherapy
8. Ext. Stimulus
