Hydrocephalus, cysts and syrinxes
Margaret Esiri, Waney Squier, Daniel Perl in Oppenheimer's Diagnostic Neuropathology, 2006
Hydrocephalus (in the vernacular, water on the brain) in practice means enlarged cerebral ventricles. The term ‘external hydrocephalus’, which denoted enlargement of the cerebral subarachnoid spaces, has dropped out of use, as it is no more than an aspect of cerebral atrophy. The terms ‘communicating’ and ‘non-communicating’ hydrocephalus are still used. They denote the presence or absence of communication, via the apertures of the fourth ventricle, between the ventricular system and the subarachnoid space. Mention has already been made (p.29) of naked-eye changes in cases of hydrocephalus, and of some of the causes of ventricular enlargement.
Introduction
Elizabeth M. Anderson, Bernie Spain in The Child with Spina Bifida, 2016
This introduction presents an overview of key concepts discussed in the subsequent chapters of this book. The book is about spina bifida and hydrocephalus many of the physical, intellectual and family problems described in it are shared by children handicapped in other ways and the suggestions made here about how these problems can be met will also be relevant to them. Parents of spina bifida children frequently have anxieties about their children's health, especially in the early years: severe damage to the kidneys caused by urinary infections and blockage of the shunt which controls the hydrocephalus may have extremely serious consequences. Children with congenital hydrocephalus which is not associated with spina bifida or with hydrocephalus acquired in early childhood, perhaps from meningitis, are likely to have very similar learning difficulties. The children were tested individually on a battery selected to elicit information about overall intellectual ability and sub-test performance patterning; verbal ability; visuo-motor and visuo-perceptual ability; and hand function.
Head and neck
Spencer W. Beasley, John Hutson, Mark Stringer, Sebastian K. King, Warwick J. Teague in Paediatric Surgical Diagnosis, 2018
The size and shape of the vault of the skull are determined by growth of the brain. The commonest abnormality of the cranium is hydrocephalus, which is caused by congenital abnormalities of the cerebrospinal fluid (CSF) pathway or by acquired obstruction of the CSF flow from haemorrhage, infection or tumour. Hydrocephalus is confirmed by observing an enlarged head circumference relative to that expected on a standard growth chart. Spina bifida with Arnold-Chiari malformation was once the commonest cause of hydrocephalus, but now intracranial haemorrhage in very premature babies is seen more frequently. Lymphatic malformations involving the neck or side of the face may present as non-tender swellings at birth. In the absence of haemorrhage into the cysts, they transilluminate. They may enlarge rapidly from both infection and haemorrhage. Reactive hyperplasia of the lateral cervical lymph nodes is by far the most frequent cause of a lump in the side of the neck.
Actualities in hydrocephalus classification and management possibilities
Published in Neurological Research, 2000
Retrospective analysis in co-operative study of hydrocephaus at institutions of members of the Research Committee on Intractable Hydrocephalus sponsored by the Ministry of Health and Welfare of Japan was performed to determine the functional prognosis. For clinico-epidemiological study we classified nontumoral hydrocephalus into eight types based on its etiology and the time of onset. Analysis of the 1,450 cases of hydrocephalus stored in the database obtained from the study was performed in order to find intractable factors In terms of factors related to patients and management. Analysis of the cases stored in the database revealed that the following types and conditions were found to be intractable factors: 1. Early fetal hydrocephalus. 2. Overt neonatal hydrocephalus. 3. Hydrocephalus associated with such severe brain malformations as hydranencephaly, holoprosencephaly and lissencephaly. 4. Hydrocephalus associated with severe brain damage. 5. Hydrocephalus associated with epilepsy. 6. Hydrocephalus shunted late after detection. 7. Hydrocephalus complicated by a shunting operation. It is impossible to determine prior to treatment whether or not a shunting operation is indicated for the patient with intractable factors, however, they may be a useful pre-operative indicator of prognosis. For the management of hydrocephalus, secondary intractable hydrocephalus may be preventable if we treat it appropriately before it becomes intractable. [Neurol Res 2000; 22: 127-130]
Hydromechanical Testing in Non-communicating Hydrocephalus to Select Patients for Microsurgical Third Ventriculostomy
Published in British Journal of Neurosurgery, 1989
To select adult patients with benign non-communicating hydrocephalus for microsurgical third ventriculostomy, cerebrospinal fluid (CSF) pressure, intercompartmental flow of CSF, and CSF draining capacity were measured in 14 patients with clinical high pressure hydrocephalus and 5 patients with clinical normal pressure hydrocephalus. The testing was of value in selecting patients with high pressure hydrocephalus for third ventriculostomy. Based on the clinical picture and the hydromechanical balance between the two separate CSF compartments one could distinguish two different patterns: (1) unbalanced high pressure hydrocephalus which improved after third ventriculostomy, and (2) balanced high pressure hydrocephalus which had to have a ventriculo-atrial shunt. All patients with normal pressure hydrocephalus had an almost balanced hydrocephalus, and the testing was shown to be of no value in this small group.
Attentional skills and executive functions in children with early hydrocephalus
Published in Developmental Neuropsychology, 1996
Jack Fletcher, Bonnie Brookshire, Susan Landry, Timothy Bohan, Kevin Davidson, David Francis, Harvey Levin, Michael Brandt, Larry Kramer, Robin Morris
Measures of executive functions (Tower of London, Wisconsin Card Sorting Test), focused attention (cancellation tasks), and selective attention (Stroop test) were administered to 116 school‐age children with shunted hydrocephalus, arrested (un‐shunted) hydrocephalus, and no hydrocephalus. The results revealed that children with shunted hydrocephalus solved fewer problems on the Tower of London task and achieved fewer categories on the Wisconsin Card Sorting Test than children with arrested and no hydrocephalus. However, most indices of executive functions derived from these two measures did not significantly differentiate the three groups. Children with shunted hydrocephalus also performed more poorly on the focused and selective attention tasks. However, their poorer performance was related to brain defects influencing motor speed and the transfer of information across the corpus callosum and not to specific effects of hydrocephalus. Children with hydrocephalus do demonstrate problems with attention and problem‐solving skills. These differences are not as large as those observed on measures of spatial cognition and are not readily explained by hypotheses involving frontal lobe control of executive functions.
Related Knowledge Centers
- Brain
- Subarachnoid Space
- Stenosis
- Intracranial Pressure
- Cerebrospinal Fluid
- Ventricular System