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478578
Hydrocephalus
Description
paeds-neurology Mind Map on Hydrocephalus, created by v.djabatey on 12/01/2014.
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paeds-neurology
Mind Map by
v.djabatey
, updated more than 1 year ago
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Created by
v.djabatey
almost 11 years ago
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Resource summary
Hydrocephalus
obstruction to the flow of CSF
-> dilatation of ventricular sys prox to obstruction site
within ventricular sys or aqueduct
non communicating or obstructive hydrocephalus
causes
congenital malformation
aqueduct stenosis
atresia of outflow foramina of 4th ventricle (Dandy-Walker formation)
Chiari malformation
post fossa neoplasm or vascular malformation
intraventricular haemorrhage in preterm infant
at arachnoid villi (site of absorption of CSF)
communicating hydrocephalus (failure to reabsorb CSF)
causes
subarachnoid haemorrhage
meningitis e.g. pneumococcal, tuberculous
untreated
grossly enlarged head
downward deviation of the eyes (setting sun sign)
Rx
ventriculoperitoneal shunt
for drainage of symptomatic hydrocephalus
extra length of shunt tubing is left in peritoneal cav to allow for child's growth
mainstay
shunts can malfunction
due to blockage or infection (usually coag -ve staph)
then need replacing or revision
ventriculoatrial shunt
right atrial catheters need revision w/ growth
w/ regulatory valves
to avoid overdrainage of fluid
can cause low Pa headaches
for symptomatic relief of raised ICP & reduce risk of neuro damage
ventriculostomy via endoscopic Rx
clinical features
disprop large head circumference or excessive growth rate
in infants w/ condition as skull sutures haven't fused
the skull sutures separate, the ant fontanelle bulges & scalp vv become distended
fixed downward gaze or sun setting of eyes
an advanced sign
older children
sx & signs of raised ICP
diag
antenatal ultrasound screening
routine cranial ultrasound screening in pretermies
for suspected hydrocephalus
initial assessment
cranial ultrasound in infants
CT or MRI
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