Hydrocephalus
I am sure that you have heard a lot about this term hydrocephalus and you have seen a child with this condition. But, do you really know what hydrocephalus is?
This is a condition wherein there is an increased amount of cerebrospinal fluid (CSF) under increased pressure with abnormal enlargement of the cerebral ventricles.
The causes of hydrocephalus can be classified into
1. Obstructive
2. Overproduction of CSF
Obstructive hydrocephalus can be:
1. Noncommunicating and due to
– congenital malformations
– neoplasms or any space occupying lesions especially in the posterior fossa
– inflammatory processes resulting in progressive gliosis of the Sylvian aqueduct like subarachnoid hemorrhage, meningitis and postmeningitis states and intrauterine infections like TORCH disease
2. Communicating type of obstructive hydrocephalus could be due to:
– deficient reabsorption of CSF
– congenital deficiency of arachnoid villi
Clinically, patients with hydrocephalus may vary with clinical course depending on their age of onset and the presence of pre-existing structural lesions.
Patients may present with enlarging head circumference, change in facies, anterior fontanel may be tense and bulging, the scalp veins are prominent and distended especially during crying, and there may be downward deviation of the eyes so that the iris appears to set beneath the lower lid. This is called “setting sun” sign. Other signs include:
– nystagmus
– ptosis
– strabismus
– papilledema
– spasticity
– opisthotonus
– cry is shrill, brief and high- pitched
– vomiting
– somnolence
– irritability
– seizures and
– alterations of the vital signs
These patients are best seen and examined by the neurologists who will do tests prior to treatment. This is an emergency and warrants immediate interventions.