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Dr. VASHDEV KHIMANI ASSISTANT PROFESSOR DEPT. OF NEUROSURGERY LUMHS JAMSHORO
Hydrocephalus derived from Greek word means water on brain. It is an abnormal accumulation of CSF in ventricles or cavities of brain
Functions of CSF 1. Shock absorber 2. Delivering nutrients to the brain removing waste products. 3. Flow between cranium & spine & compensate for changes in intracranial blood volume.
Ventricular system is made up of 4 ventricles 2 lateral ventricles Third ventricle 4 th ventricle
Flow of CSF
Congenital: T hat present at birth Genetic defects (Aqueduct stenosis) Developmental defect (Neural tube defect) Intraventricular hemorrhage complication of premature birth.
Aqueduct of Stenosis.
Causes. ACQUIRED : That present after the birth Meningitis Brain tumor Traumatic head injury Subarachnoid hemorrhage.
Traumatic head injury
Normal pressure hydrocephalus (NPH) Triad of(Gate disturbance, urinary incontinence, dementia ).
Ex vacuo hydrocephalus Present when brain insult leads atrophy
Ex vacuo hydrocephalus
Pediatric age group Irritability, poor feeding, lethargic, vomiting, delayed milestones. SIGNS Increase OFC (occipitofrontal circumference) Visible scalp veins Sunset eye phenomenon Bulging fontenella
Adult age group Headache Vomiting Blurred vision Dizziness Altered level of consciousness Papilloedema Cushing triad (Bradycardia, Hypertension, Respiratory irregularities)
Routine hematological Ultrasound brain CT scan brain MRI brain
Ultrasound brain Size of ventricles Corticomantle thickness
Normal Ctscan Abnormal Ctscan
When CSF is clear Patient is a febrile Normal CSF status Glucose 40-60mg/dl protein 15-40mg/dl Cells 0-5/cm predominantly lymphocyte
Flow is essence of life
Specific Treatment Brain bypass surgery Ventriculoperitoneal shunt Ventriculoatrial shunt Ventriculoplural shunt
Complications of VP Shunt. Shunt Malfunctioning. Shunt block. Shunt Infection. Slit like
Hydrocephalus Definition-Hydrocephalus is a disorder in which the cerebral ventricular system contains an excessive amount of cerebrospinal fluid (CSF)
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