Zusammenfassung der Ressource
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