Normal Pressure Hydrocephalus
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Normal pressure hydrocephalus (NPH) is a condition where cerebrospinal fluid (CSF) absorption is reduced, causing increased pressure in the ventricles of the brain. It typically affects elderly individuals and presents as a triad of symptoms - impaired gait, urinary incontinence, and cognitive impairment. Diagnosis involves MRI or CT scans showing ventricle enlargement. Treatment is usually surgical placement of a shunt to drain CSF from the brain ventricles to the abdominal cavity or heart, which can improve symptoms. However, shunt surgery also carries risks of infection, obstruction, or over-drainage of CSF.
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Normal pressure hydrocephalus (NPH) is a reversible cause of dementia characterized by the classic triad of dementia, gait disturbance, and urinary incontinence. It is caused by excess cerebrospinal fluid in the brain's ventricles without increased fluid pressure. NPH typically affects older adults and can be diagnosed using criteria including an evaluation of symptoms, imaging scans, and lumbar puncture results. Treatment involves CSF shunting procedures, which can significantly improve symptoms in around 60% of NPH patients. Prognosis is generally good with sustained improvement possible after surgery, though shunt complications do occur in around 38% of cases.
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Hydrocephalus is a condition where there is excessive accumulation of cerebrospinal fluid (CSF) in the brain, resulting in increased pressure on brain tissues. It occurs when there is an imbalance between the production and absorption of CSF, blocking its flow. Symptoms vary depending on age but can include headache, nausea, vision issues. It is diagnosed using brain imaging and treated primarily by surgically inserting a shunt to drain CSF out of the brain. Prognosis depends on cause and treatment success, though many children with hydrocephalus can lead normal lives with treatment.
Neurological sources of gait dysfunction
1. There are many types of neurological gait disorders that can arise from damage or dysfunction in different parts of the brain or nervous system.
2. Hemiplegic gait results from weakness on one side of the body, like after a stroke, causing the affected leg to drag and circumduct during walking.
3. Parkinsonian gait is slow, stiff, and shuffling, with loss of arm swing and difficulty initiating movement.
Hydrocephalus
Hydrocephalus is a condition where there is an excess of cerebrospinal fluid (CSF) in the brain, resulting in increased pressure inside the skull. It occurs when there is an imbalance between the production and absorption of CSF, causing it to accumulate in the ventricles of the brain. Symptoms vary depending on age but can include an enlarged head size, vomiting, irritability, and problems with vision. Treatment involves surgically placing a shunt to divert fluid from the brain ventricles to another part of the body to decrease pressure. Complications from hydrocephalus and its treatment can include infections, mechanical issues with shunts, and neurological problems.
Hydrocephalus
Hydrocephalus is a condition caused by impaired circulation and resorption of cerebrospinal fluid (CSF) in the brain. It can be obstructive, caused by blockages within the ventricular system, or non-obstructive/communicating, caused by malfunctions of the arachnoid villi. Common causes include lesions or malformations in the posterior fossa, tumors, meningitis, or intrauterine infections. Symptoms include irritability, vomiting, headache, and cognitive/behavioral changes. Imaging studies like CT scans and MRI are used for diagnosis. Treatment options include medical management with drugs to reduce CSF production or surgical placement of a VP shunt. Long-term outcomes include increased risks for
Hydrocephalus presentation
Hydrocephalus is a condition where there is an abnormal accumulation of cerebrospinal fluid in the brain. It can be congenital or acquired later in life due to infections, tumors or hemorrhages. The excess fluid increases intracranial pressure which can damage the brain. Symptoms depend on age but include headaches, vomiting, vision problems and cognitive decline. Treatment is usually surgery to implant a shunt to drain fluid from the brain ventricles to the abdomen to be absorbed. Complications can include infections, shunt malfunctions or continued brain damage if not treated promptly.
Hydrocephalus
Hydrocephalus is an abnormal accumulation of cerebrospinal fluid in the brain that causes increased intracranial pressure. It can be caused by excessive CSF production, decreased absorption, or obstruction of flow. Symptoms vary depending on age but include headache, vomiting, visual changes, irritability, and cognitive or motor problems. Diagnosis involves imaging like CT or MRI of the brain. Treatment options include medical management but primarily involves surgically diverting CSF through shunts or endoscopic procedures to reduce pressure and allow drainage. Complications can arise from shunt malfunctions or infections.
Surgical management of NPH
This document provides information on the surgical management of normal pressure hydrocephalus (NPH). It discusses the history and examination findings suggestive of NPH, describes imaging techniques used for diagnosis, and outlines special tests that can aid in evaluation. It also reviews the options for surgical treatment, including ventriculoperitoneal, lumboperitoneal, and endoscopic third ventriculostomy procedures. Factors influencing shunt responsiveness are summarized, and guidelines for proceeding to shunt placement based on diagnostic classification are presented.
Csf Presentation 2009
The document provides information on CSF Dynamics and their SinuShunt device for treating hydrocephalus. It discusses the shortcomings of traditional shunts, including numerous complications from overdrainage and short lifetimes. The SinuShunt aims to address these issues by draining cerebrospinal fluid from the brain ventricles directly into the transverse sinus, mimicking natural drainage and minimizing complications. Over 200 SinuShunts have been implanted with fewer reported complications compared to traditional shunts.
neurosurgery.Hydrocephalus.(dr.ali omer)
This document discusses hydrocephalus, including its definition, types, causes, clinical features, diagnosis, and management. Hydrocephalus is an increase in cerebrospinal fluid (CSF) within the cranium, usually associated with increased intracranial pressure. It can be communicating or non-communicating depending on whether CSF flow is blocked. Causes include congenital defects, infections, hemorrhages, and masses. Clinical features vary depending on age but include head enlargement, vomiting, headaches, and vision problems. Diagnosis involves imaging like ultrasound, CT, or MRI. Management includes medical treatment, surgical procedures to bypass blockages or drain CSF, and shunt placement. Complications can arise from shunts
Patient Advocate Stephen Dolle's FDA Stamp Conference Recommendations
This is a paper of FDA STAMP Conference recommendations FDA patient advocate and CNS shunt user Stephen Dolle, which he wrote for this 1999 Conference in Bethesda, MD, a conference he was responsible for, yet was not invited to speak on panel, nor was his new solution oriented DiaCeph Test included in the conference. STAMP was held in part due to Dolle's 1996 FDA petition on anti siphon shunts, of which he was an affected user, and FDA upheld, but oddly withheld their Sept. 1998 ruling from the Federal Register. Dolle did everything he could possibly do to bring progress in CNS shunts, yet wasn't allowed.
You can read from his recommendations back in 1999 that he had a vision to bring progress in this area. Since 1999, CNS shunts have been plagued by widespread device failures, more notably programmable shunts.
CNS shunts users today face new risks from years of over use of CT scanning, which DiaCeph would have reduced. Some patients have had as many as 100 and 200.
I can be reached at contact[at]dollecommunications[dot]com and via my blog.
FDA STAMP Conference on CNS Shunts Agenda January 1999
Conference agenda for the 1999 STAMP Conference on CNS Shunts and anti siphon devices in Bethesda, MD, brought about by patient advocate Stephen Dolle and his efforts with a 1996 petition to FDA on anti siphon shunts. Dolle oddly was not invited to speak or be a panelist, or to have his new mHealth DiaCeph Test included in the conference. In the years since, CNS shunts have suffered significant medical device and design failures, most of which have not been reported to FDA, which Dolle attributes to the cover ups dating back to this conference. As of 2015, Dolle has undergone 12 shunt operations, with the majority of these caused by failing CNS shunts that were never reported to FDA. The more your know!
FDA's David L. Daly July 2002 Response and Denial to include CNS shunts in ne...
The letter responds to a request to add CNS shunts to a postmarket surveillance list under Section 522 of the FDA. It apologizes for the delayed response. While CNS shunts meet the criteria of being a Class II implantable device, the FDA believes postmarket surveillance is not needed as issues are related to understanding the disease and improving device materials, not significant postmarket safety questions. The letter states postmarket surveillance would not provide benefit and manufacturers will not be required to conduct it for CNS shunts.
Hydrocephalus
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DIC is an acquired syndrome characterized by systemic intravascular coagulation and thrombosis. It has multiple potential causes including infection, cancer, trauma, and obstetric complications. The morbidity and mortality of DIC depends on the extent of thrombosis and bleeding from depletion of platelets and coagulation factors. Diagnosis involves evaluating for a condition associated with DIC, signs of thrombosis or bleeding, and abnormal lab tests like low platelet count and elevated D-dimer. Treatment focuses on treating the underlying cause and providing supportive care like plasma or platelet transfusions.
Competency Case Study Week 10 (2)
A VP shunt patency study is performed to evaluate if a ventriculoperitoneal (VP) shunt placed to treat hydrocephalus is functioning properly. The shunt drains excess cerebrospinal fluid (CSF) from the brain ventricles into the abdomen. Radiopharmaceuticals like Tc-99m DTPA or In-111 DTPA are injected into the shunt reservoir and imaged as they flow through the tubing and into the abdomen. Normal studies show radiotracer passing smoothly through the entire shunt system. Abnormal studies may indicate a blockage or reflux of CSF back into the ventricles, suggesting shunt malfunction. Dynamic imaging is performed and processed images
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Patient Advocate Stephen Dolle's FDA Stamp Conference Recommendations
Patient Advocate Stephen Dolle's FDA Stamp Conference Recommendations
FDA STAMP Conference on CNS Shunts Agenda January 1999
FDA STAMP Conference on CNS Shunts Agenda January 1999
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FDA's David L. Daly July 2002 Response and Denial to include CNS shunts in ne...
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This document provides an overview of cerebrospinal fluid (CSF) anatomy and physiology, as well as disorders of CSF circulation. Key points include: CSF is formed in the choroid plexus and circulates through the ventricles before being absorbed into venous sinuses; intracranial pressure is regulated by CSF production, circulation and absorption; hydrocephalus is an excess accumulation of CSF within the brain that can be communicating or non-communicating; management involves medical treatment, temporary procedures like external ventricular drainage, and surgical options like shunts or endoscopic third ventriculostomy.
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Death by Neurological Criteria and Organ Donation: Bill Knight
Bill Knight explains the concept of death by neurological criteria and the complexities surrounding organ donation in such situations.
Bill discusses the process of dying, the definition of death, how to approach the neurologically dead patient and how to consider organ donation.
Death is a complex topic.
Due to advancements in medical technology and processes, the definition of death is a challenging one.
Bill talks at length about the definition of death by the neurological criteria. Dying is an active process, whereas death is an event.
The acceptance of death by the neurological criteria is often challenging as Bill will highlight. Bill talks about the care of the dying or dead patient.
There is a point at which care will transition from supporting the patient to supporting the organs. This is still good care.
There is an alignment of parallel intentions – first and foremost resuscitation of patients and then failing that, proceeding to considering and actioning organ donation. This is important due to the shortage of viable donor organ worldwide.
The donation process itself is complex. Bill provides his thoughts. He insists that an intensivist be involved as this has been shown to increase the number of viable and healthy organs made available.
The timing is also important. Available evidence does not support the need for immediate procurement after brain death. Taking time to optimise perfusion and allow recovery and cardiac function is appropriate and should be done.
Bill also discusses other treatment options at the time of death such as optimising endocrine function.
Finally, Bill will provide some practical considerations when communicating with the dead patient’s family. This involves being clear on your messaging. You are supporting organs, not life.
To reinforce this point, Bill suggests not examining or talking to the patient. He also recommends using all of the available hospital support services.
Similarly, it is best to not introduce the topic of organ donation to the family yourself as the treating clinician. Utilise the Organ Procurement Organisations (or similar services) and get them involved early to speak with the family.
Join Bill Knight in his talk on the North American perspective on Organ Donation, brain death and management of the brain dead donor prior to organ donation.
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Hydrocephalus
Hydrocephalus is a condition where excess cerebrospinal fluid accumulates in the brain, causing increased intracranial pressure. It results from an imbalance between the production and absorption of cerebrospinal fluid, which normally circulates around the brain and spinal cord. The main symptoms of hydrocephalus vary depending on age, but include headache, nausea, gait issues, and cognitive decline. It is typically diagnosed through brain imaging scans and spinal taps. The standard treatment is surgically placing a shunt to drain fluid from the brain to other parts of the body, though endoscopic procedures to create openings in the brain ventricles are also used. Complications can include shunt malfunctions requiring additional surgeries
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This document discusses increased intracranial pressure. It can result from an increase in brain tissue, blood, or cerebrospinal fluid within the skull. Common causes include head injuries, brain tumors, strokes, and hydrocephalus. Symptoms include restlessness, changes in consciousness, changes in vital signs, headaches, nausea, vomiting, pupil changes, and decreased motor function. Treatment involves managing symptoms, monitoring intracranial pressure, administering medications to reduce pressure such as mannitol and diuretics, and surgical intervention if needed.
ICP-Head-injury.ppt
This document discusses increased intracranial pressure. It can result from an increase in brain tissue, blood, or cerebrospinal fluid within the skull. Common causes include head injuries, brain tumors, strokes, and hydrocephalus. Symptoms include restlessness, changes in consciousness, changes in vital signs, headaches, nausea, vomiting, pupil changes, and decreased motor function. Treatment involves managing symptoms, monitoring intracranial pressure, administering medications to reduce pressure such as mannitol and diuretics, and surgical intervention if needed.
Asphyxia
This document provides an outline and overview of asphyxia management. It begins with definitions of related terms like anoxia, hypoxia, and discusses perinatal asphyxia. It then covers clinical features like signs seen in mild, moderate and severe hypoxic-ischemic encephalopathy. Investigations discussed include MRI, CT, ultrasound and EEG. Management involves supportive care, anticonvulsants, fluid management, glucose control and therapeutic hypothermia to reduce secondary brain injury.
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This document provides guidelines for assessing and managing acute stroke based on the RCP guidelines from 2002. It defines stroke and outlines that it is a clinical diagnosis requiring immediate assessment and treatment. It describes diagnosing ischemic versus hemorrhagic stroke through imaging and investigating potential causes. Stroke patients should be treated in a specialized stroke unit with a multidisciplinary team to improve outcomes. Certain lower risk patients may qualify for early supported discharge or home management.
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- Common birth injuries include caput succedaneum, cephalohematoma, subgaleal hemorrhage. They present as swelling, discoloration of scalp and resolve spontaneously in most cases.
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Syncope
Syncope, or fainting, is a relatively common problem that is often misdiagnosed. It is caused by a temporary drop in blood pressure and loss of consciousness but typically resolves quickly without medical intervention. The most common causes are neurally-mediated, due to an overactive vagus nerve, or cardiac-related such as arrhythmias. A thorough history and physical exam can help determine the underlying reason, while tilt table testing or carotid sinus massage may be used for diagnosis. Treatment depends on the identified cause but may include lifestyle changes, medication, or a pacemaker for recurrent episodes caused by bradycardia. Driving restrictions apply depending on the frequency and severity of syncopal episodes to prevent injury.
Syncope
Syncope, or fainting, is a relatively common problem that is often misdiagnosed. It is caused by a temporary drop in blood pressure and loss of consciousness. The most common causes are neurally-mediated syncope, cardiac arrhythmias, and orthostatic hypotension. A thorough history, physical exam, and diagnostic tests like carotid sinus massage and tilt table testing can help identify the underlying cause. Treatment depends on the cause but may include lifestyle changes, medications, or pacemaker implantation in severe cases. Proper diagnosis and management of syncope is important as it can occasionally lead to injuries or accidents.
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Hypoxic Ischemic Encephalopathy (HIE) occurs when a term infant experiences intrapartum asphyxia and lack of oxygen. It can lead to death or disabilities like cerebral palsy. Diagnosis involves assessing the infant at birth using the APGAR score and neurological staging. Imaging tools like MRI are useful for showing patterns of brain injury. HIE management aims to prevent further brain damage through measures like temperature control and treating seizures, while newer treatments target excitotoxicity and oxidative stress.
Hie ppt
Hypoxic Ischemic Encephalopathy (HIE) occurs when a term infant experiences intrapartum asphyxia and lack of oxygen. It can cause death or disabilities like cerebral palsy. Diagnosis involves assessing the infant at birth using the APGAR score and neurological staging. Imaging tools like MRI are useful to detect brain injury patterns. HIE management aims to prevent further brain damage through temperature control, seizure treatment, and potentially neuroprotective drugs. The condition remains a major cause of newborn mortality and morbidity.
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