It is estimated that 1% of children who survive a bacterial meningitis will develop hydrocephalus. Hydrocephalus can be defined broadly as a disturbance of cerebrospinal fluid csf formation, flow, or absorption, leading to an increase in volume occupied by this fluid in the central nervous system cns. Hydrocephalus merely denotes an increase in the volume of csf and thus of the cerebral ventricles ventriculomegaly although hydrocephalus is typically referred to as either being obstructive or communicating, this can lead to confusion as to the underlying cause of ventriculomegaly as the terms are referring to different aspects of the underlying pathophysiology namely why and where. Choroid plexus papillomas and choroid plexus carcinomas can secrete cerebrospinal. Hydrocephalus etiology definition of hydrocephalus. Hydrocephalus is a disorder in which an excessive amount of cerebrospinal fluid csf accumulates within the cerebral ventricles andor subarachnoid spaces, resulting in ventricular dilation and increased intracranial pressure icp. Children with spina bifida have to cope with lifelong medical care. Original research the pathophysiology of idiopathic normal pressure hydrocephalus. If a baby with spina bifida has hydrocephalus, a surgeon can put in a shunt. It is important to remember that this term does not imply that it is hereditary. Development of these complications may result from improper antibiotic therapy. Conditions covered are hydrocephalus, communicating hydrocephalus. When you have too much, though, it puts harmful pressure on your brain.
Aside from the congenital etiology, hydrocephalus can result from a series of neurological conditions such as head. This excess fluid causes an abnormal widening of spaces in the brain called ventricles ventriculomegalia and can create a harmful pressure on brain tissue. Hydrocephalus etiology definition of hydrocephalus etiology. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Acquired hydrocephalus acquired hydrocephalus is due to. Find out information about obstructive hydrocephalus. Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid csf occurs within the brain. The pathophysiology of otitic hydrocephalus the journal. Mccance, msn, phd professor college of nursing university of utah salt lake city, utah section editors valentina l. Huether, msn, phd professor emeritus college of nursing university of utah salt lake city, utah kathryn l. According to this view, intact ventricular csf absorption means that intraventricular csf mixes freely with interstitial fluid isf by free. Anatomy and physiology brain, spinal cord and their. Congenital hydrocephalus is caused by congenital syphilis and toxoplasmosis.
Often the exact cause of congenital hydrocephalus cannot be determined but known causes can include. Hydrocephalus pediatrics merck manuals professional. This condition could also be termed a hydrodynamic csf disorder. Hydrocephalus in children kristopher t kahle, abhaya v kulkarni, david d limbrick jr, benjamin c warf hydrocephalus is a common disorder of cerebral spinal. Essential concepts of pathophysiology, 1 1 introduction to clinical science, 3 judy craft and christopher gordon. Its literal translation being water in the head comes from the words. Results understanding the fundamentals of the production, absorption, dynamics, and pathophysiology of csf is crucial for addressing hydrocephalus.
The pathophysiology of congenital and neonatal hydrocephalus is not well understood although the prognosis for patients with this disorder is far from optimal. Hydrocephalus association 12th national conference. The ventricles and subarachnoid space appear enlarged secondary to loss of brain tissue. Hydrocephalus is a central nervous system disorder characterized by excessive accumulation of cerebrospinal fluid csf in the ventricles of the brain. With respect to causes of hydrocephalus, an anatomical approach is used highlighting abnormalities that can impede cerebrospinal. Pathophysiology the large head attributed to water on the brain has long attracted interest and speculation.
Csf is a clear fluid that surrounds the brain and spinal cord. Intraventricular haemorrhage ivh is defined as the eruption of blood in the cerebroventricular system and occurs mostly secondary to intracerebral haemorrhage ich in adults. The most common symptom of hydrocephalus in children is an enlarged skull. Hypothetically, hydrocephalus can be subdivided into 3 forms. The physiology, pathogenesis, and etiology of hydrocephalus. Causes of hydrocephalus intraventricular hemorrhage. New concepts in the pathogenesis of hydrocephalus hydrocephalus is a central nervous system disorder characterized by excessive accumulation of cerebrospinal fluid csf in the ventricles of the brain. Hydrocephalus basic concepts and general pathology. Commonly applied antibiotics in upper respiratory tract infections and acute otitis reduced the incidence of intracranial complications. Study guide for understanding pathophysiology pdf free download.
Congenital hydrocephalus is when a child is born with an excessive accumulation of cerebrospinal fluid csf in the brain. Pathophysiology of congenital and neonatal hydrocephalus. Aside from the congenital etiology, hydrocephalus can result from a series of neurological conditions such as head trauma, intracranial hemorrhage, tumor, or infection of the central nervous system at any time during life. In acquired hydrocephalus, an extrinsic cause is often readily apparent by history or on the basis of imaging findings. The term hydrocephalus, in its broadest sense, means an increased amount of fluid in the. This chapter focuses on the pathology of hydrocephalus in children. Although this disorder is common in childhood, hydrocephalus. Study guide for understanding pathophysiology this page intentionally left blank study guide for understanding pathophysiology sue e.
Normal pressure hydrocephalus nph is remarkable for two reasons. Hydrocephalus that develops only after the fontanelles have closed does not increase head circumference or cause the fontanelle to bulge but can markedly and rapidly increase intracranial pressure. Cognitive and physical handicap can occur as a result of hydrocephalus. General pathology primary ciliary dyskinesia cerebral ventricle slit. The resulting pressure of the fluid against brain tissue is what causes hydrocephalus. Cause of hydrocephalus the balance between production and absorption of csf is critically important. Sep 27, 2017 hydrocephalus research and treatment have advanced tremendously in the last 20 years. Otitic hydrocephalus neonatology jama neurology jama. Hydrocephalus can be congenital, or present at birth. Hydrocephalus can happen at any age, but it occurs more frequently among infants and adults 60 and over. Many theories of normal pressure hydrocephalus nph stress the importance of ischemia in the deep white matter. Its similarities to parkinsons disease, dementia and other chronic neurodegenerative conditions make diagnosis challenging, requiring clinicians to be alert to the signs and symptoms that. Alternate theories stress a reduction in superficial. Paediatrics and congenital hydrocephalus, 161 hydrocephalus.
Obstructive hydrocephalus obstructive hydrocephalus also called noncommunicating hydrocephalus refers to excess accumulation of cerebrospinal fluid csf due to structural blockage of csf flow within the ventricular system. Infants commonly present with progressive macrocephaly whereas children older than 2 years generally present with signs and symptoms of intracranial hypertension. Sep 27, 2014 discussing physiology and neuroanatomy of cerebrospinal fluid and pathophysiology of hydrocephalus for usmle step 1. Del bigio mr 2010 neuropathology and structural changes in hydrocephalus. Today, the focus of hydrocephalus research is on pathophysiology, shunting eg, new shunt materials and programmable valve design, and minimally invasive techniques of treatment. Although hydrocephalus was once known as water on the brain, the water is actually cerebrospinal fluid csf a clear fluid that surrounds. Hydrocephalus is an expansion of the ventricular system resulting from. Background hydrocephalus is a central nervous system cns disorder characterized by the abnormal accumulation of cerebrospinal fluid csf in cerebral ventricles, resulting in their dilatation. The second most common reason for being sued for negligence in neurosurgery is a problem related to hydrocephalus management the first being spinal surgery. The pathophysiology of otitic hydrocephalus the journal of. It typically results in paralysis of the lower limbs, hydrocephalus, incontinence of bowel and bladder, lack of sensation below the lesion, and dislocated hips. Normal pressure hydrocephalus nph cleveland clinic. We report a patient with hydrocephalus who developed levodopa responsive parkinsonism and severe bradyphrenia associated with shunt malfunction and revision. Infants commonly present with progressive macrocephaly whereas children older than 2 years.
Improvement of the current state of diagnosis and treatment of hydrocephalus involves a better understanding of the pathophysiology of hydrocephalus. Obstructive hydrocephalus article about obstructive. Hydrocephalus may result from inherited genetic abnormalities such as the genetic defect that causes aqueductal stenosis or developmental disorders such as those associated with neural tube defects including spina bifida and encephalocele. Hydrocephalus neuroanatomy and physiology of csf for usmle. Though hydrocephalus was recently estimated to affect 1. The causes of hydrocephalus are still not well understood. Hydrocephalus ex vacuo is often classified as a form of hydrocephalus, however, this is a misnomer as it is not a true hydrocephalus. Pathophysiology of parkinsonism due to hydrocephalus. Congenital hydrocephalus genetic and rare diseases. The most common cause of acquired hydrocephalus is the development of a lesion in the brain, which may result from a tumour, stroke, or complications of head injuries. The pathophysiology of otitic hydrocephalus remains controversial. Hydrocephalus definition hydrocephalus is an abnormal expansion of cavities ventricles within the brain that is caused by the accumulation of cerebrospinal fluid. Approximately 500 milliliters about a pint of csf is formed within the brain each day, by epidermal cells in structures collectively called the choroid plexus.
Hydrocephalus etiology article about hydrocephalus. Abstract background normal pressure hydrocephalus is a disease, which results. Hydrocephalus is the buildup of too much cerebrospinal fluid in the brain. Infantile hydrocephalus is a complex condition with both genetic and environmental causes. Hydrocephalus, pathogenesis, osmotic gradients, paravascular. Background hydrocephalus is a central nervous system cns disorder characterized by the abnormal accumulation of cerebrospinal fluid csf in cerebral ventricles, resulting in their. Pdf the three major clinical manifestations of spina bifida hydrocephalus, paraplegia. Hydrocephalus is the most common cause of abnormally large heads in neonates. Atdhd hlarrested hydrocephalus definitions csf pressure has normalized pressure gradient between ventricles and parenchyma has been dissipated ventricular size remains stable or decrease new neurological deficits do not appear advancing psychomotor development with age. Hydrocephalus is a severe complication of ivh that can serve as an independent predictor of increased mortality.
This occurs from an irregularity in the production and absorption of the fluid which causes. This typically causes increased pressure inside the skull. Congenital hydrocephalus occurs in roughly two or three out of every 1,000 live births. Mechanisms of hydrocephalus after intraventricular. During the symposium, 84 papers were presented by 240 contributors from 14 countries. Apr 28, 2014 hydrocephalus is a central nervous system disorder characterized by excessive accumulation of cerebrospinal fluid csf in the ventricles of the brain. A shunt is a small hollow tube that will help drain the fluid from the babys brain and protect it from too much pressure. Hydrocephalus is a common but complex condition caused by physical or functional obstruction of csf flow that leads to progressive ventricular dilatation. Otitic hydrocephalus is a rare complication of acute mastoiditis, which is accompanied by lateral sinus thrombosis. Magnetic resonance imaging revealed periaqueductal edema involving medial substantia nigra. Today, the focus of hydrocephalus research is on pathophysiology, shunting eg, new.
Many different therapies are often required to manage symptoms or functional impairments resulting from hydrocephalus. Hi t i l thistorical account hippocrates described fluid in brain galen described ventricles vesalius showed the anatomyvesalius showed the anatomy megendimegendi performed first. Jun 04, 2018 hydrocephalus can be defined broadly as a disturbance of formation, flow, or absorption of cerebrospinal fluid csf that leads to an increase in volume occupied by this fluid in the cns. The pathophysiology of chronic noncommunicating hydrocephalus. Epidemiology of hydrocephalus in children the ispn guide. Hydrocephalus is the buildup of fluid in the cavities ventricles deep within the brain. Hydrocephalus fact sheet national institute of neurological.
Congenital hydrocephalus is present in 3 of live births 97. Surgical treatment for hydrocephalus can restore and maintain normal cerebrospinal fluid levels in the brain. The disorder can present at any age as a result of a wide variety of different diseases. Often misunderstood and misdiagnosed, normal pressure hydrocephalus nph is a disease of the elderly that is on the rise as the population ages. Hydrocephalus pediatrics merck manuals professional edition. Congenital hydrocephalus also can be caused by prenatal toxoplasmosis infection. The pathophysiology of these conditions has been outlined in this article. Normal pressure hydrocephalus nph is a condition that is caused by an abnormal build up of cerebrospinal fluid in the ventricles cavities or spaces of the brain.
The author has done much research on hydrocephalus. However, the good news is that the overall standard of care for patients with hydrocephalus appears to have greatly improved over the last 10 years with the advent of better facilities for investigation, new approaches to treatment, and. Hydrocephalus is an excess accumulation of cerebrospinal fluid in the ventricular system resulting in the enlargement of the intracranial cavity. Methods key points on the physiology of csf as well as the diagnostic and treatment options for hydrocephalus are discussed. Hydrocephalus that develops only after the fontanelles have closed does not increase head. This is the most common form of hydrocephalus in children and is almost always associated with increased intracranial pressure icp. Hydrocephalus is a common disorder of cerebral spinal fluid csf physiology resulting in abnormal expansion of the cerebral ventricles. Csf plays a crucial role in the protection and homeostasis of neural tissue. It has been argued that involvement of the superior sagittal sinus, by, at least, a mural thrombus is a necessary component of this disease. In the majority of infants with hydrocephalus, however, an extrinsic cause is not easily discerned. Commonly applied antibiotics in upper respiratory tract infections and acute. A major obstacle to advancing our knowledge of the causes of this disorder and the cellular responses that accompany it is the multifactorial nature of hydrocephalus. The pathophysiology of idiopathic normal pressure hydrocephalus.
Download the pdf to view the article, as well as its associated figures and tables. This type of hydrocephalus can affect individuals of all ages and may be caused by injury or disease. The evidence gary s gronseth, md, faan professor and executive vice chair neurology university of kansas medical center. This volume is a compre hensive description of the current knowledge in this area, and it may help to define what is known and to find new strategies to understand the patho genesis, pathophysiology, diagnosis, and treatment of the hydrocephalic process. Concepts of altered health states9th edition succeed in your pathophysiology text with this 9th edition of porths pathophysiology. Csf physiology and pathophysiology of hydrocephalus. Despite the fact that spina bifida dates back to stone age, its etiology remains unknown. Feb 24, 2014 acquired hydrocephalus develops at the time of birth or at some point afterward. Although this disorder is common in childhood, hydrocephalus can occur at any age and results in significant cognitive and physical handicap. The capacity of normal lateral and third ventricles is approximately 20 ml, whereas the total csf volume in an adult is 120150 ml. Hydrocephalus research and treatment have advanced tremendously in the last 20 years. Hydrocephalus is the result of an imbalance between the formation and drainage of cerebrospinal fluid csf. Pdf pathophysiology of congenital and neonatal hydrocephalus. This is the most common form of hydrocephalus in children and is almost always associated with increased.
Because csf is made continuously, medical conditions that block its normal flow or absorption will result in an overaccumulation of csf. Understand basic pathophysiology related to hydrocephalus and available treatments. Hydrocephalus associated with shunt malfunction can cause a distinct parkinsonian syndrome with greater dysfunction of projections from the medial substantia nigra to anterior striatum than in idiopathic parkinsons disease. Hydrocephalus knowledge for medical students and physicians.