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Questions and Answers
What is the primary cause of hydrocephalus classified under acquired conditions?
Which symptom is NOT commonly associated with hydrocephalus in infants?
Which classification of hydrocephalus describes hydrocephalus where there is a communication failure between the ventricles?
Which is a clinical feature that suggests normal pressure hydrocephalus?
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Which of the following congenital factors can lead to hydrocephalus?
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Which neurological sign is often observed in adults with hydrocephalus due to pressure on the tectal plate?
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What is the typical epidemiological incidence of hydrocephalus in the Czech Republic per live born infants?
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Which physical examination finding can indicate increased intracranial pressure in children with hydrocephalus?
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Study Notes
Introduction
- Hydrocephalus is characterized by an accumulation of cerebrospinal fluid (CSF) within the brain's ventricles.
- Causes include excessive production of CSF, obstruction to flow, or impaired reabsorption, leading to increased intracranial pressure (ICP).
Epidemiology
- Nigeria reports an incidence of approximately 34 cases per 100,000 people.
- The Czech Republic shows an incidence of 6.35 cases per 10,000 live-born infants.
- Gender distribution is generally equal, except in cases of X-linked hydrocephalus like Bickers-Adams syndrome.
Classification
- Communicating (non-obstructive) and non-communicating (obstructive) hydrocephalus.
- Hydrocephalus ex vacuo, which occurs due to brain atrophy.
- Classifications also differentiate between acute vs chronic and primary vs secondary forms.
Aetiology
- Congenital Causes: Include intrauterine infections (TORCHES), trauma, and malformations such as Dandy-Walker malformation and aqueductal stenosis.
- Acquired Causes: Result from trauma leading to intraventricular hemorrhage (IVH), subarachnoid hemorrhage (SAH), central nervous system (CNS) infections, or tumors.
Clinical Manifestation
- Symptoms vary according to age, cause, location of obstruction, duration, and rapidity of onset.
Clinical Features
- Infants: Symptoms include poor feeding, irritability, reduced activity, and vomiting.
- Children: Symptoms such as slowed mental capacity, headaches, neck pain (indicating tonsillar herniation), vomiting, vision problems, stunted growth, walking difficulties due to spasticity, and drowsiness.
- Adults (Normal Pressure Hydrocephalus): Characterized by gait abnormalities, memory impairment, and urinary incontinence.
Physical Examination
- Infants: Head enlargement, sutural diastasis, dilated scalp veins, thin and shiny scalp, tense fontanelle, and setting-sun sign.
- Children: Physical findings include papilledema, failure of upward gaze, Macewen sign, unsteady gait, and possible sixth nerve palsy.
- Adults: Findings may include papilledema or optic atrophy, failure of upward gaze or accommodation, indicating pressure on the tectal plate.
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Description
This quiz explores the key aspects of hydrocephalus, including its definition, embryology, epidemiology, etiology, diagnosis, treatment, and prevention strategies. Gain a comprehensive understanding of this condition and its implications on health. Perfect for students and medical professionals alike.
