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Hydrocephalus

  1. Is defined as increase in volume of CSF due to impaired absorption / circulation or increased production.
  2. Formation of CSF
    1. Primarily in the ventricular system by the choroid plexus
    2. Extrachoroidal sources – capillary endothelium
  3. Absorption of CSF
    1. Primarily through arachnoid villi
    2. Also from – lymphatic channel
    3. along nerve root sleeves
  4.  Circulation of CSF

 

 

Types

  1. Hydrocephalus resulting from obstruction within the ventricular system is called obstructive or noncommunicating hydrocephalus
  2. Hydrocephalus resulting from obliteration of the subarachnoid cistern or malfunction of the arachnoid villi is called non obstructive or communicating hydrocephalus. 

Most common cause of congenital hydrocephalus → Aque ductal stenosisQ

 

Arnold Chiari malformation Type I

 

Deformity consists of displacement of the cerebellar tonsils into the cervical canal. Typically produces symptoms during adolescence or adult life and is usually not associated with hydrocephalus

 

Arnold chiari malformation Type II

 

Due to displacement of the inferior vermis, pons and medulla into the cervical canal. It is characterized by progressive hydrocephalus and a myelomeningocele

 

Dandy Walker malformation –

Consists of a cystic expansion of the fourth ventricle in the posterior fossaQ, 90% of patients have hydrocephalus.





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