HYDROCEPHALUS
HYDROCEPHALUS
HYDROCEPHALUS
BY LEX-MEDLIFE CENTER
(DR I. MWANGALA + DR M. KAZEVU
OBJECTIVES
DEFINITION
CSF CIRCULATION
CAUSES
CLASSIFICATION
PATHOPHYSIOLOGY
CLINICAL FEATURES
DIFFERENTIAL DIAGNOSIS
INVESTIGATION
TREATMENT
COMPLICATIONS
DEFINITION
Is a disorder characterized by dilatation of ventricles due to blockage
of cerebrospinal fluid flow (CSF) or due to increased secretion or due
to defective absorption of CSF
FUNCTIONS OF CSF
Provide a cushioning effect on the CNS and dampens the effects of
trauma.
Removal of metabolites from the CNS.
Provides a stable ionic environment for the CNS under normal
conditions.
Brain and spinal cord float in CSF whose buoyant effect results in
reduction of traction exerted upon the nerves and blood vessels
connected to these CNS structures.
CAUSES
I. An excess of CSF production - (in rare condition of choroid plexus
papilloma and choroid plexus Ca, Choriod plexus congestion as in
meningitis.
II. CSF flow obstruction (an obstructive hydrocephalus) - aqueductal
stenosis, brain lesion and tumour, infections (meningitis), intraventricular
bleeds, Dandy Walker cyst
III. Failure of reabsorption (a communicating hydrocephalus) -
obstruction at the arachnoid granulations, sinus thrombosis, arachnoiditis,
Congenital infection especially toxoplasmosis, Leukemic infilteration,
Subarachnoid space adhesions (Rare) due to: Post hemorrhagic or Post
meningitic
IV. Associated abnormalities- Dandy-Walker syndrome, Arnold-Chiari
malformation, Aqueductal stenosis
CLASSIFICATION
Classification I of Hydrocephalus
Communicating type: Ventricles communicate freely into the
subarachnoid space.
Here there is defective absorption of CSF following any inflammation, subarachnoid
haemorrhage or trauma.
Normal pressure hydrocephalus- Occur in cerebral atrophy, ventricles
are dilated but the pressure is not raised.
Aka Hydrocephalus ex vacuo,Cause of NPH may be known but most often it’s
idiopathic.
Noncommunicating type: Obstruction is in the ventricle or its exit, due to
any tumors or any inflammatory process.
Movement of CSF out of the ventricular system is impeded (e.g. blockage at cerebral
aquaduct/foramina of 4th ventricle- foramina of luschka and magedie)
CLASSIFICATION II OF HYDROCEPHALUS