CURSO DE INGLÉS PROFESIONAL PARA LA SALUD II Mikhail FIDAROV

TEMA
HYDROCEPHALUS

Sección:………………………….… Apellidos:……………………………………
Docente: Dr. Mikhail FIDAROV Nombres:……………………………………

1. Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF)

occurs within the brain.
2. This typically causes increased pressure inside the skull. Older people may
have headaches, double vision, poor balance, urinary incontinence, personality
changes, or mental impairment. In babies, it may be seen as a rapid increase in
head size. Other symptoms may include vomiting, sleepiness, seizures,
and downward pointing of the eyes.
3. Hydrocephalus can occur due to birth defects or be acquired later in life. Associated
birth defects include neural tube defects and those that result in aqueductal stenosis.
4. Other causes include meningitis, brain tumors, traumatic brain injury, intraventricular
hemorrhage, and subarachnoid hemorrhage. The four types of hydrocephalus are
communicating, noncommunicating, ex vacuo, and normal pressure. Diagnosis is
typically made by physical examination and medical imaging.
5. Hydrocephalus is typically treated by the surgical placement of a shunt system. A
procedure called a third ventriculostomy is an option in some people.
6. Complications from shunts may include overdrainage, underdrainage, mechanical
failure, infection, or obstruction.
7. This may require replacement. Outcomes are variable, but many people with shunts
live normal lives.[1] Without treatment, death or permanent disability may occur.
8. About one to two per 1,000 newborns have hydrocephalus. Rates in the developing
world may be higher. Normal pressure hydrocephalus is estimated to affect about 5
per 100,000 people, with rates increasing with age.
9. Description of hydrocephalus by Hippocrates dates back more than 2,000 years. The
word hydrocephalus is from the Greek hydōr, meaning 'water' and kephalē, meaning
'head'.
CURSO DE INGLÉS PROFESIONAL PARA LA SALUD II Mikhail FIDAROV

SINGS AND SYMPTOMS

10. The clinical presentation of hydrocephalus varies with chronicity. Acute dilatation of
the ventricular system is more likely to manifest with the nonspecific signs and
symptoms of increased intracranial pressure (ICP).
11. By contrast, chronic dilatation (especially in the elderly population) may have a more
insidious onset presenting, for instance, with Hakim's triad (Adams' triad).[citation
needed]
12. Symptoms of increased ICP may include headaches, vomiting, nausea, papilledema,
sleepiness, or coma.
13. With increased levels of CSF, there have been cases of hearing loss due to CSF
creating pressure on the auditory pathways or disrupting the communication of inner
ear fluid.
14. Elevated ICP of different etiologies have been linked to sensorineural hearing loss
(SNHL). Transient SNHL has been reported after the loss of CSF with shunt
surgeries.
15. Hearing loss is a rare but well-known sequela of procedures resulting in CSF loss.
Elevated ICP may result in uncal or tonsillar herniation, with resulting life-
threatening brain stem compression.[citation needed]
16. Hakim's triad of gait instability, urinary incontinence, and dementia is a relatively
typical manifestation of the distinct entity normal-pressure hydrocephalus.
17. Focal neurological deficits may also occur, such as abducens nerve palsy and
vertical gaze palsy (Parinaud syndrome due to compression of the quadrigeminal
plate, where the neural centers coordinating the conjugated vertical eye
movement are located).
18. The symptoms depend on the cause of the blockage, the person's age, and how
much brain tissue has been damaged by the swelling.[citation needed]
19. In infants with hydrocephalus, CSF builds up in the central nervous system (CNS),
causing the fontanelle (soft spot) to bulge and the head to be larger than expected.
Early symptoms may also include:
20. Eyes that appear to gaze downward
Irritability
Seizures
Separated sutures
Sleepiness
21. Vomiting
CURSO DE INGLÉS PROFESIONAL PARA LA SALUD II Mikhail FIDAROV

Symptoms that may occur in older children can include:

Brief, shrill, high-pitched cry
Changes in personality, memory, or the ability to reason or think
Changes in facial appearance and eye spacing (craniofacial disproportion)
22. Crossed eyes or uncontrolled eye movements
Difficulty feeding
Excessive sleepiness
Headaches
Irritability, poor temper control
23. Loss of bladder control (urinary incontinence)
Loss of coordination and trouble walking
Muscle spasticity (spasm)
Slow growth (child 0–5 years)
Delayed milestones
24. Failure to thrive
Slow or restricted movement
Vomiting
25. Because hydrocephalus can injure the brain, thought and behavior may be adversely
affected. Learning disabilities, including short-term memory loss, are common
among those with hydrocephalus, who tend to score better on verbal IQ than on
performance IQ, which is thought to reflect the distribution of nerve damage to the
brain.
26. Hydrocephalus that is present from birth can cause long-term complications with
speech and language. Children can have difficulties such as nonverbal learning
disorder, understanding complex and abstract concepts, retrieving stored
information, and spatial/perceptual disorders.
27. Children with hydrocephalus are often known in having the difficulty in understanding
the concepts within conversation and tend to use words they know or have heard.
However, the severity of hydrocephalus can differ considerably between individuals,
and some are of average or above-average intelligence.
28. Someone with hydrocephalus may have coordination and visual problems, or
clumsiness. They may reach puberty earlier than the average child (this is
called precocious puberty). About one in four develops epilepsy.[citation needed]

CAUSE:
CURSO DE INGLÉS PROFESIONAL PARA LA SALUD II Mikhail FIDAROV

Congenital:
29. Congenital hydrocephalus is present in the infant prior to birth, meaning the fetus
developed hydrocephalus in utero during fetal development. The most common
cause of congenital hydrocephalus is aqueductal stenosis, which occurs when the
narrow passage between the third and fourth ventricles in the brain is blocked or too
narrow to allow sufficient cerebral spinal fluid to drain. Fluid accumulates in the
upper ventricles, causing hydrocephalus.
30. Other causes of congenital hydrocephalus include neural-tube defects, arachnoid
cysts, Dandy–Walker syndrome, and Arnold–Chiari malformation. The cranial
bones fuse by the end of the third year of life.
31. For head enlargement to occur, hydrocephalus must occur before then. The causes
are usually genetic, but can also be acquired and usually occur within the first few
months of life, which include intraventricular matrix hemorrhages in premature
infants, infections, type II Arnold-Chiari malformation, aqueduct atresia and stenosis,
and Dandy-Walker malformation.[citation needed]
32. In newborns and toddlers with hydrocephalus, the head circumference is enlarged
rapidly and soon surpasses the 97th percentile. Since the skull bones have not yet
firmly joined together, bulging, firm anterior and posterior fontanelles may be present
even when the person is in an upright position.[citation needed]
33. The infant exhibits fretfulness, poor feeding, and frequent vomiting. As the
hydrocephalus progresses, torpor sets in, and infants show lack of interest in their
surroundings. Later on, their upper eyelids become retracted and their eyes are
turned downwards ("sunset eyes") (due to hydrocephalic pressure on
the mesencephalic tegmentum and paralysis of upward gaze).
34. Movements become weak and the arms may become tremulous. Papilledema is
absent, but vision may be reduced. The head becomes so enlarged that they
eventually may be bedridden.
35. About 80–90% of fetuses or newborn infants with spina bifida—often associated
with meningocele or myelomeningocele—develop hydrocephalus.
Acquired:
36. This condition is acquired as a consequence of CNS infections, meningitis, brain
tumors, head trauma, toxoplasmosis, or intracranial hemorrhage (subarachnoid or
intraparenchymal), and is usually painful.
TIPE
CURSO DE INGLÉS PROFESIONAL PARA LA SALUD II Mikhail FIDAROV

37. The cause of hydrocephalus is not known with certainty and is probably multifactorial. It
may be caused by impaired CSF flow, reabsorption, or excessive CSF production.
38. Obstruction to CSF flow hinders its free passage through the ventricular system
and subarachnoid space (e.g., stenosis of the cerebral aqueduct or obstruction of
the interventricular foramina secondary to tumors, hemorrhages, infections or
congenital malformations) and can cause increases in ICP
39. Hydrocephalus can also be caused by overproduction of CSF (relative obstruction)
(e.g., choroid plexus papilloma, villous hypertrophy).
40. Bilateral ureteric obstruction is a rare, but reported, cause of hydrocephalus.
41. Hydrocephalus can be classified into communicating and noncommunicating
(obstructive). Both forms can be either congenital or acquired.