Hydrocephalus

The term " Hydrocephalus " refers to an excessive CSF accumulation in the normal cavities (the ventricles) of the brain. Hippocrates first reported the term "hydrocephalus" in newborns and babies with head swelling.

 

The CSF is produced inside special brain pockets called ventricles. The fluid circulates around the brain and the spinal cord, acting as bothprotecting and support for the central nervous system. It is constantly produced and aspirated at a rate of about half a liter per day.

 

Classification

The hydrocephalus species are the following three:

  1. Primary or Idiopathic (unknown cause)
  2. Secondary – from
    • bleeding (subarachnoid or intracerebral)
    • injury
    • tumor or bladder
    • intracranial surgery
    • meningitis
    • sewer drainage (Sylvius aqueduct)
    • overproduction of CSF (choroid matrix)

 

Congenital (abnormality in the fetal or neonatal period)

 

Depending on its evolution, the hydrocephalus is subdivided into acid or chronic.

 

Child hydrocephalus

The majority of cases of hydrocephalus occur in childhood due to either a developmental disorder of the anatomical elements of the brain and skull, or due to a tumor or other dysplasia. It is extremely important for the pediatrician to diagnose hydrocephalus immediately and refer these cases to a neurosurgeon for further investigation, treatment and follow-up. Untimely discovery of hydrocephalus can have tragic effects on the health and development of a child. Increasing intracranial pressure can directly threaten the life of the child and require urgent neurosurgery.

 

Symptoms

Symptoms of increased intracranial pressure are vomiting, headache, drowsiness, and downward deviation of the eyes (setting-sun phenomenon) can reveal the so-called optic nodule edema, which is an important sign of increased intracranial pressure. It may be necessary to repair the valve many times in a child's life.

 

Modern imaging methods such as MRI scans give us new information about hydrophilic pathophysiology.

 

How is hydrocephalus treated?

The most effective treatment of obstructive hydrocephalus is by removing its cause, e.g. through volume exclusion, which causes obstruction at the point of communication of the brain's bellies. The usual treatment of the condition in caseswhen the cause cannot be emancipatedis the placement of ventricular valvular drainage (a brain valve).

 

Hydrocephalus Valve History

The first attempts to surgically bypass CSF occurred at the beginning of the 20th century with elastic tubules or the opening of artificial passages within the abdominal system using an endoscope. The construction of the first silicone valve to bypass the CSF was made in 1952, while the first surgical procedure was carried out in 1958. Since then, the valves have undergone multiple developments.Today, valves, or shunts, are programmed with a special ultrasound machine without the need for surgical replacement.

 

Information by PANAGIOTIS KOKKALIS

Specialized Pediatric Neurosurgeon
 
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