Hydrocephalus - Edubirdie

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

105

Pages:

4
Author:

Mariam A. A.

Hydrocephalus Definition Accumulation of CSF within ventricles causing dilation and elevated ICP Types Communicating/non-obstructive Non-communicating/obstructive CSF moves out of the ventricles Blocked CSF blow between the ventricles Description But cannot be absorbed by the arachnoid villi Most commonly at the cerebral aqueduct More common Tumours Causes Post-infection Aqueduct stenosis TB Most common Haemorrhagic stroke Causes: SAH Degenerative wear and tear (most common) Most common Chronic inflammation Meningitis Genetics Congenital issues Congenital malformations Normal pressure hydrocephalus Arnold-Chaiari malformation CSF over production TORCH infections Scarring Normal pressure hydrocephalus Ventricular dilation but no elevated in CSF pressure 50% of cases are idiopathic Other causes: SAH, meningitis, head injury or malignancy Usually part of a triad of: Parkinsonian gait Urinary incontinence Dementia Clinical features Headache Nausea Vomit Ataxia Double vision ALC Alerted GCS Sleepy Altered personality/behavioural changes More irritable Raised ICP features Cushing Papilledema CST disruption UMN signs Investigations CT head First line Ventricle enlargement Most commonly B/L Not present in every case Loss of sulcal gyral pattern Subtle hypodensity around ventricular margins Due to CSF exudation from ventricles MRI head Gold standard Ventriculomegaly Tinning and upward bowing of the corpus callosum Midline changes Lumbar drain trial Most reliable method of determining if a patient will benefit from a shunt LP Predicts success of permanent shunt surgery Provides temporary symptom relief Management Surgical Definitive management depends on cause Insertion of an external ventricular treatment First line in acute setting CSF Shunt insertion E.g. ventriculo-peritoneal (VP) shunt or ventriculo-arterial (VA) shunt Endoscopic third ventriculostomy Removal of obstruction e.g. tumor Choroid plexus resection MDT Physiotherapy OT Psychology Complications Surgery complications Urinary incidence Visual and sensory issues Physical and motor issues Balance issues Memory and cognitive issues Confusion, difficulty concentrating Slowed movement Complications post-surgery Shunt malfunction Shunt infection Shunt blockage