Hydrocephalous

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Overview

Hydrocephalus is the symptomatic accumulation of cerebrospinal fluid (CSF) inside the cerebral ventricles. This accumulation may be due to obstruction in the normal flow of the CSF, or to problems with absorption into the venous system by the Pacchionian arachnoid granulations, or due to excessive production of CSF. Dandy first describes hydrocephalus as communicating and non-communicating (obstructive) in early 1913, and since then, many more classifications were proposed. In adults, there are four different types; obstructive, communicating, hypersecretory, and normal pressure hydrocephalus (NPH). Congenital or developmental hydrocephalus is often present at birth and is often part of a genetic syndrome or spinal dysraphism.

Surgical treatment with a ventricular shunt placement is the first treatment option. Endoscopic third ventriculostomy (ETV) and choroid plexus cauterization are possible options in suitable forms of hydrocephalus. Acute hydrocephalus without prompt treatment can result in brain herniation and death. In children, hydrocephalus has a mortality rate of 0 to 3% depending on the duration of the follow-up.

Symptoms

Headache.

Blurred or double vision.

Abnormal eye movements.

Abnormal enlargement of a toddler's head.

Sleepiness or sluggishness.

Nausea or vomiting.

Unstable balance.

Poor coordination.

Causes

bleeding inside the brain – for example, if blood leaks over the surface of the brain (subarachnoid haemorrhage)

blood clots in the brain (venous thrombosis)

meningitis – an infection of the membranes surrounding the brain and spinal cord.

brain tumours.

head injury.

Risk factors

brain or spinal cord tumors.

infections of the central nervous system such as bacterial meningitis.

injury or stroke that causes bleeding in the brain.

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Complications

Brain damage caused by hydrocephalus can be significant and depends on multiple factors. Newborns with severe advanced hydrocephalus at birth will likely have brain damage and physical disabilities. Patients with less severe hydrocephalus who receive adequate treatment may have a relatively healthy life. Complications are associated with hydrocephalus progression, medical treatment, and surgical procedure.


Visual changes

Temporal lobe herniation

Cognitive dysfunction

Incontinence

Gait problems

Electrolyte imbalance

Metabolic acidosis

Shunt obstruction

Shunt disconnection

Under shunting

Over shunting

Subdural hematoma

Subdural hygroma

Seizures

Extraneural metastases

Hardware erosion

Peritonitis

Inguinal hernia

Perforation of abdominal organs

Intestinal obstruction

Volvulus

Ascites 

Septicemia

Endocarditis

Pulmonary hypertension

Radiculopathy and arachnoiditis (lumboperitoneal shunts)

Prevention

Prenatal care. Make sure you get prenatal care during pregnancy. ...

Vaccinations. ...

Safety equipment. ...

Buying safe gear for younger children