500 likes | 1.2k Views
HYDROCEPHALUS. Dr. VASHDEV KHIMANI ASSISTANT PROFESSOR DEPT. OF NEUROSURGERY LUMHS JAMSHORO. Definition. 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
E N D
HYDROCEPHALUS Dr. VASHDEV KHIMANI ASSISTANT PROFESSOR DEPT. OF NEUROSURGERY LUMHS JAMSHORO
Definition 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.
Anatomy. Ventricular system is made up of 4 ventricles 2 lateral ventricles Third ventricle 4th ventricle
TYPES OF HYDROCEPHALUS Congenital: That present at birth Genetic defects (Aqueduct stenosis) Developmental defect (Neural tube defect) Intraventricular hemorrhage complication of premature birth.
Causes. • ACQUIRED: That present after the birth • Meningitis • Brain tumor • Traumatic head injury • Subarachnoid hemorrhage.
Normal pressure hydrocephalus (NPH) • Triad of(Gate disturbance, urinary incontinence, dementia ).
Ex vacuohydrocephalus Present when brain insult leads atrophy
PRESENTATION 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)
Investigations Routine hematological Ultrasound brain CT scan brain MRI brain
Ultrasound brain • Size of ventricles • Corticomantle thickness
CT scan brain Normal Ctscan Abnormal Ctscan
Ideal candidate for surgery 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
When CSF is infectedLumber puncture / FontenellaTappingExternal ventriculostomy drain 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