GH 5036        

 

Hydrocephalus

Key concept

Communicating / Noncommunicating  

CSF production

Drainage pathway

Monro Kellie hypothesis

     

Introduction  - Documents 

 

  

 


Background 

Hydrocephalus can be an emergency if sudden and severe.

 

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Pathophysiology

Hydrocephalus can be an emergency if sudden and severe.

Communicating v non-communicating  

The anatomy of the pathway for CSF drainage includes bottle-necks at the foramina of Monro, the aqueduct of Sylvius, and  the foramina of Luschka and Magendie.

CSF production   

The anatomy of the pathway for CSF drainage includes bottle-necks at the foramina of Monro, the aqueduct of Sylvius, and  the foramina of Luschka and Magendie.

Drainage pathway

The anatomy of the pathway for CSF drainage includes bottle-necks at the foramina of Monro, the aqueduct of Sylvius, and  the foramina of Luschka and Magendie.

Monro Kellie hypothesis  

In the Monro Kellie Model the volume of CSF is one

Acute v chronic 

Acute hydrocephalus versus chronic hydrocephalus.

 

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Diagnosis

If acute hydrocephalus is suspected it is important to make the diagnosis as quidkly as possible.

If getting an MRI takes significantly longer than getting a CT to rule out hydrocephalus, get the CT to make sure there is nothing that requires emergency intervention, and THEN more leisurely, get the MRI

Making the diagnosis of shunt obstruction is easier in patients with a subgaleal reservoir (usually associated with a VP shunt or Omaya reservoir).  

Patients with VP shunt

Shunt tap:

CT head:

Shunt series:

 

 

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Management

Evaluate for CSF drainage access

 

  

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Complications

 

Brain herniation can complicate acute hydrocephalus. 

 

Herniation

 

Brain herniation can complicate acute hydrocephalus. 

 

Brain death 

 

Once intracranial pressure increases enough with respect to the arterial pressure blood flow to and through the brain will decrease enough that cells will start to fail metabolically and ultimately die.

 

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Self-assessment

 

1.  Hydrocephalus can be an emergency if sudden and severe.

Communicating v noncommunicating  - 

              A. 

              B.

              C.  

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2.  Hydrocephalus can be an emergency if sudden and severe.

 CSF production 

              A.

              B.

              C.

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3.  Hydrocephalus can be an emergency if sudden and severe.

Monro Kellie hypothesis

              A.

              B.

              C.

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3.  Hydrocephalus can be an emergency if sudden and severe.

Monro Kellie hypothesis

              A.

              B.

              C.

              D.

              E.

 

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