Dr. VASHDEV KHIMANI ASSISTANT PROFESSOR DEPT. OF NEUROSURGERY LUMHS JAMSHORO.

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Presentation transcript:

Dr. VASHDEV KHIMANI ASSISTANT PROFESSOR DEPT. OF NEUROSURGERY LUMHS JAMSHORO

Hydrocephalus derived from Greek word means water on brain. It is an abnormal accumulation of CSF in ventricles or cavities of brain

Functions of CSF 1. Shock absorber 2. Delivering nutrients to the brain removing waste products. 3. Flow between cranium & spine & compensate for changes in intracranial blood volume.

Ventricular system is made up of 4 ventricles 2 lateral ventricles Third ventricle 4 th ventricle

Flow of CSF

Congenital: T hat present at birth Genetic defects (Aqueduct stenosis) Developmental defect (Neural tube defect) Intraventricular hemorrhage complication of premature birth.

Aqueduct of Stenosis.

Intraventricular Hemorrhage.

Causes. ACQUIRED : That present after the birth Meningitis Brain tumor Traumatic head injury Subarachnoid hemorrhage.

Meningitis

Brain tumor

Traumatic head injury

Subarachnoid hemorrhage.

Normal pressure hydrocephalus (NPH) Triad of(Gate disturbance, urinary incontinence, dementia ).

NPH

Ex vacuo hydrocephalus Present when brain insult leads atrophy

Ex vacuo hydrocephalus

Pediatric age group Irritability, poor feeding, lethargic, vomiting, delayed milestones. SIGNS Increase OFC (occipitofrontal circumference) Visible scalp veins Sunset eye phenomenon Bulging fontenella

Adult age group Headache Vomiting Blurred vision Dizziness Altered level of consciousness Papilloedema Cushing triad (Bradycardia, Hypertension, Respiratory irregularities)

Routine hematological Ultrasound brain CT scan brain MRI brain

Ultrasound brain Size of ventricles Corticomantle thickness

Normal Ctscan Abnormal Ctscan

When CSF is clear Patient is a febrile Normal CSF status Glucose 40-60mg/dl protein 15-40mg/dl Cells 0-5/cm predominantly lymphocyte

Flow is essence of life

Lumber puncture

Fontenella tapping

Specific Treatment Brain bypass surgery Ventriculoperitoneal shunt Ventriculoatrial shunt Ventriculoplural shunt

Complications of VP Shunt. Shunt Malfunctioning. Shunt block. Shunt Infection. Slit like