Hydrocephalus (Water On The Brain) : Definition, Causes, Types, Signs, Symptoms, Diagnosis, Treatment, Shunt, & Prognosis
Definition
- Hydrocephalus refers to the increase in head size due to increase in CSF volume & increase in ventricular size of brain.
Types
1. Obstructive (Non communicating)
- Site of pathology: Formation of CSF till exit from 4th ventricle.
2. Non-obstructive (Communicating)
- Site of pathology: Basal cistern, Subarachnoid space, Absorption by arachnoid villi
Causes
1. Obstructive (Non communicating)
- Most common cause: Congenital aqueductal stenosis associated with NTDS
2. Non-obstructive (Communicating)
- Most common cause:
World: Subarachnoid haemorrhage (SAH)
India: Tuberculous meningitis > Pneumococcal meningitis
Clinical Features
- Increase in head size
- Separation of sutures (1st to separate: Cornonal suture)
- Bulging of fontanelles
- No papilloedema
Signs
- Sunset sign
Investigation
- Transcranial ultra sound (Ix of choice)
Treatment
1. Treat the cause
2. Medical
Carbonic anhydrase inhibitors
⇓
Decrease CSF production
Not effective in inflammatory conditions
3. Surgical
- Surgical shunt (Best shunt: V-P shunt Ventriculo peritoneal shunt)
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