INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal...

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INFANTILE HYDROCEPHALUS R. Faingold. Maputo 2018

Transcript of INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal...

Page 1: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele

INFANTILE

HYDROCEPHALUSR. Faingold.

Maputo 2018

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Hydrocephalus

Definition: Increased CSF volume

Etiology:

Obstruction to CSF flow

Decreased CSF absorption (NPH)

Increased CSF production

Classification in infants:

Congenital

Acquired

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Congenital Hydrocephalus

Primary aqueductal stenosis

Dandy-Walker malformation

Chiari malformation type II

Myelomeningocele

Secondary gliosis due to intrauterine viral infections

(mumps, varicella, TORCH infections)

Arachnoid cyst (posterior fossa)

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Acquired Hydrocephalus

Post meningitis

Post hemorrhage (SAH, IVH)

Vascular malformations

Neoplastic masses

Infections

Brain abscesses

Hematoma

Venous sinus thrombosis

Choroid plexus papilloma

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Epidemiology

Most common cause of hydrocephalus: acquired aqueductal

stenosis

Obstruction by infection, hemorrhage or mass

Most common congenital cause: myelomeningocele (often with

Chiari II or aqueductal stenosis)

Congenital hydrocephalus 0.5-0.8 per 1000 live births (50%

due to myelomeningocele)

100 000 shunts implanted internationally every year

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Epidemiology

Incidence of acquired hydrocephalus unknown

Congenital aqueductal stenosis: 10% hydrocephalus of the

newbown

Dandy-Walker: 2-4%

Mass lesion: 20% of all hydrocephalus in children

In developing countries: congenital and infectious

In developed countries: congenital, post- hemorrhagic,

infectious

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Clinical Manifestations in Infants

Accelerated rate of enlargement of the head

Bulging anterior fontanelles

Widening of cranial sutures

Upper motor neuron signs (brisk reflexes)

Irritability, lethargy, poor feeding

Sunset sign (forced downward deviation of eyes)

Episodic apnea and bradycardia

Signs of Increased ICP

Lethargy, vomiting, headache

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Imaging Options

U/S

CT

MRI

ICP monitoring

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Pattern of Dilatation

Stenosis of aqueduct

Dilated lateral and

third ventricle

Normal size fourth

ventricle

Communicating

hydrocephalus

Symmetrical dilatation

of the ventricles

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Suggestive of Hydrocephalus:

Enlargement of the recesses of the 3rd ventricle

Dilatation of the temporal horns of the lateral

ventricles

Interstitial edema of periventricular tissue

Effacement of cortical sulci

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Benign Enlargement of

Subarachnoid Spaces in Infants

Transient developmental

phenomenon

Most are self-limiting

Up to 16% of infants

Macrocephaly

Prominence of SAS

Mild ventricular enlargement

Typically 2-7 months

When hydrocephalus is present

= EVOH (extra-ventricular

obstructive hydrocephalus

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Increased extra-axial spaces

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Increased subarachnoid space seen on ultrasound

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Increased extra-axial spaces with dilated ventricles

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Grade IV IVH + hydrocephalus

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Page 18: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
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Page 20: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
Page 21: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
Page 22: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
Page 23: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
Page 24: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
Page 25: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
Page 26: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
Page 27: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
Page 28: INFANTILE HYDROCEPHALUS - Weebly · Most common cause of hydrocephalus: acquired aqueductal stenosis Obstruction by infection, hemorrhage or mass Most common congenital cause: myelomeningocele
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THANK YOU!

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References

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Hydrocephalus in Children

Hydrocephalus in Children

Hydrocephalus 2013 Athens

Hydrocephalus 2013 Athens

Module Hydrocephalus

Module Hydrocephalus

Hydrocephalus in Pineal and Tectal Tumors - rd.springer.com · In contrast, tectal tumors also cause obstruction of CSF pathway in the aqueduct and lead to a noncommunicating hydrocephalus;

Hydrocephalus in Pineal and Tectal Tumors - rd.springer.com · In contrast, tectal tumors also cause obstruction of CSF pathway in the aqueduct and lead to a noncommunicating hydrocephalus;

Hydrocephalus I

Hydrocephalus I

Journal Hydrocephalus

Journal Hydrocephalus

Congenital Aqueductal Stenosis: Findings at Fetal MRI That ... · Prior studies have cited congenital aqueductal stenosis (CAS) as a diagnosis of exclusion.7 However, we propose that

Congenital Aqueductal Stenosis: Findings at Fetal MRI That ... · Prior studies have cited congenital aqueductal stenosis (CAS) as a diagnosis of exclusion.7 However, we propose that

Hydrocephalus Updates

Hydrocephalus Updates

Journal of Hydrocephalus - wah.kenkyuukai.jpwah.kenkyuukai.jp/images/sys\information\20110209174237... · v J. Hydrocephalus, Vol. 1, No. 1, 2009 Journal of Hydrocephalus Volume 1,

Journal of Hydrocephalus - wah.kenkyuukai.jpwah.kenkyuukai.jp/images/sys\information\20110209174237... · v J. Hydrocephalus, Vol. 1, No. 1, 2009 Journal of Hydrocephalus Volume 1,

Evaluation of Aqueductal Stenosis by 3D Sampling ... · A 35-year-old man with partial aqueductal stenosis (patient 12). A, Sagittal T2-weighted image shows a narrowed aqueduct (arrow).

Evaluation of Aqueductal Stenosis by 3D Sampling ... · A 35-year-old man with partial aqueductal stenosis (patient 12). A, Sagittal T2-weighted image shows a narrowed aqueduct (arrow).

2c Article Hydrocephalus

2c Article Hydrocephalus

The 10 Major Subjects inHydrocephalus Research Fields · J. Hydrocephalus, Vol. 2, No. 1, 2010 v Journal of Hydrocephalus Journal of Hydrocephalus Volume 2, Number 1 2010 Hydrocephalus

The 10 Major Subjects inHydrocephalus Research Fields · J. Hydrocephalus, Vol. 2, No. 1, 2010 v Journal of Hydrocephalus Journal of Hydrocephalus Volume 2, Number 1 2010 Hydrocephalus

Hydrocephalus Catalog - Al-Aseel Medical Scientific Officealaseelmedical.com/.../uploads/2015/12/01.-Hydrocephalus-Catalog.pdf · Hydrocephalus Catalog 1st edition. 2 3 Contents VALVES

Hydrocephalus Catalog - Al-Aseel Medical Scientific Officealaseelmedical.com/.../uploads/2015/12/01.-Hydrocephalus-Catalog.pdf · Hydrocephalus Catalog 1st edition. 2 3 Contents VALVES

Take the headaches out of treating hydrocephalus · 2020-05-20 · Hydrocephalus Treatment Take the headaches out of treating hydrocephalus Hydrocephalus treatment and the need for

Take the headaches out of treating hydrocephalus · 2020-05-20 · Hydrocephalus Treatment Take the headaches out of treating hydrocephalus Hydrocephalus treatment and the need for

Genetic deletion of Rnd3 results in aqueductal stenosis leading to hydrocephalus … · Genetic deletion of Rnd3 results in aqueductal stenosis leading to hydrocephalus through up-regulation

Genetic deletion of Rnd3 results in aqueductal stenosis leading to hydrocephalus … · Genetic deletion of Rnd3 results in aqueductal stenosis leading to hydrocephalus through up-regulation

NPH NORMAL PRESSURE HYDROCEPHALUS. Adams & Hakim syndrome: symptomatic occult hydrocephalus with 'normal' CSF pressure 1965 Communicating hydrocephalus.

NPH NORMAL PRESSURE HYDROCEPHALUS. Adams & Hakim syndrome: symptomatic occult hydrocephalus with 'normal' CSF pressure 1965 Communicating hydrocephalus.

Case Presentation Hydrocephalus

Case Presentation Hydrocephalus

Genetics and Hydrocephalus - Hydrocephalus Association · Genetics and Hydrocephalus James P. (Pat) McAllister II, PhD1,2,4 Bioengineering and 1 Pediatric Neurosurgery, Primary Children’s

Genetics and Hydrocephalus - Hydrocephalus Association · Genetics and Hydrocephalus James P. (Pat) McAllister II, PhD1,2,4 Bioengineering and 1 Pediatric Neurosurgery, Primary Children’s

2. Hydrocephalus

2. Hydrocephalus

Hydrocephalus 1

Hydrocephalus 1