Hydrocephalus

Question 1

define hydrocephalus

Answer 1

excessive volume of CSF in the ventricular system of the brain caused by an imbalance between the CSF and absorption.

Question 2

how can hydrocephalus be divided?

Answer 2

• obstructive (communicating)

- non-obstructive (non communicating)

Question 3

what is normal pressure hydrocephalus?

Answer 3

• reversible cause of dementia seen in elderly patients

- secondary to reduced CSF absorption at the arachnoid villi

Question 4

what is the epidemiology of hydrocephalus?

Answer 4

• it has a bimodal distribution
• young
  elderly

Question 5

what are the presenting symptoms of general hydrocephalus?

Answer 5

• symptoms from raised ICP
• headache worse in the morning
• headache worse on lying down
• nausea and vomiting
• coma

Question 6

what are the symptoms of normal pressure hydrocephalus?

Answer 6

• dementia
• gait disturbance
• urinary incontinence

Question 7

what are the signs of hydrocephalus in neonates?

Answer 7

• increased head circumference

- sunset sign (failure of the downward gait)

Question 8

what are signs of normal pressure hydrocephalus?

Answer 8

• cognitive impairment
• gait apraxia
• hyperreflexia
• urinary incontinence

Question 9

what are the signs of obstructive hydrocephalus?

Answer 9

• low GCS
• papilloedema
• 6th nerve palsy

Question 10

what is the gold standard investigation for hydrocephalus?

Answer 10

• CT head
• MRI
• CSF
• lumbar puncture