Hydrocephalus: Difference between revisions
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==Background== | ==Background== | ||
*Caused by excessive [[cerebrospinal fluid]] accumulation, often from an obstructive process such as [[CSF shunt malfunction]] or [[subarachnoid hemorrhage]] | |||
*Patients can also suffer from nonobstructive hydrocephalus due to excessive production of [[CSF]]<ref>Shprecher D. et al. Normal pressure hydrocephalus: diagnosis and treatment. Curr Neurol Neurosci Rep. 2008;8(5):371-376.</ref> | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 06:36, 24 September 2016
Background
- Caused by excessive cerebrospinal fluid accumulation, often from an obstructive process such as CSF shunt malfunction or subarachnoid hemorrhage
- Patients can also suffer from nonobstructive hydrocephalus due to excessive production of CSF[1]
Clinical Features
- Headache
- Diplopia
- Ocular Palsy - 6th nerve palsy, strabismus
- Papilledema
- Nausea and Vomiting
- Altered Mental Status
- Peds (in addition to above):
- Large fontanelles
- Dilated scalp veins
- "Cracked pot" sound on percussion
- Irritability
- Increased lower extremity tone
- Remember that Babinski sign is normal up to 3 years of age
Differential Diagnosis
- Psuedotumor cerebri
- Meningitis
- Temporal arteritis
- Cavernous sinus or cerebral sinus thrombosis
- Migraine, Tension, or Cluster headaches
- Pre-eclampsia
- Hypertensive urgency/emergency
- Carbon monoxide poisoning
- Febrile Headache (ex: pyelonephritis, nonspecific viral infection)
Evaluation
- Physical Exam to assess for papilledema or neuro defects
- CT Brain non contrast
- In acute cases will see dilated ventricles and tight sulci
- In chronic cases (loss of tissue with age, alcoholism, etc) will see dilated ventricles with large amount of CSF in sulci
Management
Disposition
See Also
External Links
References
- ↑ Shprecher D. et al. Normal pressure hydrocephalus: diagnosis and treatment. Curr Neurol Neurosci Rep. 2008;8(5):371-376.