Hydrocephalus

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 Note : The terms communicating and noncommunicating hydrocephalus are used to indicate extraventricular obstructive hydrocephalus and intraventricular obstructive hydrocephalus, respectively.

Normal CSF : 

• 75 % produced in ventricles (choroid plexus)
• 25% Extrachoroidally in capillary endothelium

Normal Rate of production : 20ml/hr

Normal Volume : 

• 50 ml (infants)
• 150 ml (Adults)

Image courtesy :  DrShiviMudgal. - MedicoNotebook

Non communicating Hydrocephalus = Intraventricular Obstructive.

Causes :

1. Most common - Aqueductal Stenosis (MCQ)
2. Aqueductal gliosis
3. Vein of gallen malformation (Invg: MR-Angio)
4. Arnold Chiari malformation
5. Dandy Walker Malformation

Communicating = Extraventricular obstructive.

i.e - obstruction at basal cistern level

- Has large 4th ventricle.

Causes :

1. TBM - Contrast enhancing Basal exudates on CT
2. Pneumococcal Meningitis
3. Leukaemic Infiltrates
4. Large IVH in preterm

First Sign of increased ICT :

• In children : Sutural seperation
• In Adults : Erosion of posterior clenoid process.

Invg of choice for Hydrocephalus : MRI

Treatment :

• Medical - Furosemide , Acetazolamide

• Surgery - Ventriculoperitoneal shunt (complication - blockage , infection usually by coag. negative Staph epidermidis)

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