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Emergency: requires immediate attention
Hydrocephalus in Adult
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Emergency: requires immediate attention

Hydrocephalus in Adult

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Contributors: Carolyn Zyloney MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Hydrocephalus occurs when there is active distention of the ventricular system of the brain. It can result from abnormal cerebrospinal fluid (CSF) production, obstruction of CSF flow, or impaired CSF absorption. It can be congenital (eg, aqueductal stenosis) or acquired (eg, meningitis). There are communicating and noncommunicating forms of hydrocephalus.

Noncommunicating hydrocephalus is due to an obstruction of CSF flow within the ventricular system. Some cases are due to congenital malformations affecting the ventricular system, whereas other cases are due to mass lesions or tumors compressing part of the ventricular system.

Communicating hydrocephalus occurs when there is no obvious sign of obstruction within the ventricular system and is often due to impaired CSF absorption in the arachnoid villi surrounding the brain. Causes of communicating hydrocephalus include overproduction of CSF due to choroid plexus tumors, normal pressure hydrocephalus, and the sequela of meningitis or subarachnoid hemorrhages.

Increases in intracranial pressure (ICP) usually accompany the development of hydrocephalus. Signs and symptoms usually reflect increased ICP and may include headache, nausea / vomiting, and papilledema. Infants with hydrocephalus can develop an enlarged head circumference. Acute cases of hydrocephalus can lead to hemodynamic instability, coma, or death. Chronically, patients can develop intellectual impairment or memory changes, coordination and motor problems, urinary incontinence, and visual impairments.

Hydrocephalus due to an acute increase in intracranial pressure is a medical emergency and can potentially become fatal without neurosurgical intervention. Patients with more indolent hydrocephalus who lack symptoms of increased ICP can sometimes be monitored clinically and radiologically. Definitive treatment of hydrocephalus usually requires the placement of a ventriculoperitoneal shunt; however, there are several other treatment options available for select patient populations. Prognosis depends on the cause of hydrocephalus and timing of medical intervention.

Codes

ICD10CM:
G91.9 – Hydrocephalus, unspecified

SNOMEDCT:
230745008 – Hydrocephalus

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Hydrocephalus is often caused by an underlying medical condition or brain injury, including:
Several other conditions can cause symptoms that may mimic the presenting symptoms of hydrocephalus, but typically would not reveal significant ventricular enlargement on neuroimaging:

Best Tests

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Therapy

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References

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Last Reviewed: 04/27/2018
Last Updated: 04/27/2018
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Emergency: requires immediate attention
Hydrocephalus in Adult
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View all Images (2)
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Hydrocephalus (Infant) : Gait disturbance, Irritability, Papilledema, Poor feeding
Copyright © 2018 VisualDx®. All rights reserved.