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Causes of hydrocephalus. Examples of hydrocephalus caused in extraventricular and intraventricular are shown..
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Hydrocephalus is widely known as “hydrocephaly” or “water in the brain,” a building up of abnormal cerebrospinal fluid in the brain ventricles. Due to this abnormality, the size of the head becomes larger and increases the pressure in the skull. This pressure compresses the brain and causes damage to the brain. Identification by imaging techniques...
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... En la mayoría de los casos se asoció a edema transependimario. 11 Todos los pacientes fueron tratados con shunt que presentaban mecanismo "anti-siphon". Las presiones fueron medidas en milímetros de agua (mmH20). ...
Cuál es la presión de drenaje óptima en hidrocefalias tumorales obstructivas? Análisis de factores subyacentes al sobredrenado valvular, revisión de casos y desarrollo de protocolo quirúrgico. RESUMEN Introducción: La hidrocefalia es una complicación frecuente dentro de la patología tumoral del SNC. La colocación de válvulas de derivación ventrículo-peritoneal (VDVP) en estos casos es, al día de la fecha, la práctica estándar para tratar esta patología y prevenir las complicaciones y comorbilidades que esta conlleva. Al momento, no existe un protocolo ni una presión valvular inicial establecida para estos pacientes, en los cuales hemos observado una tendencia al sobredrenado de líquido cefalorraquídeo (LCR). El objetivo de este trabajo es analizar nuestra experiencia en el tratamiento de hidrocefalias obstructivas secundarias a patología tumoral, determinar factores relacionados al advenimiento de sobredrenado, el manejo terapéutico del mismo y subsiguientemente protocolizar de manera sencilla y económica la colocación de este tipo de prótesis así como identificar una presión terapéutica que reduzca el riesgo de sobredrenado. Materiales y métodos: Estudio monocéntrico, analítico, retrospectivo de una cohorte de pacientes operados en nuestra institución por hidrocefalia obstructiva secundaria a patología tumoral entre los años 2013-2022. Se analizaron historias clínicas, imágenes y protocolos quirúrgicos. Se identificaron aquellos pacientes que desarrollaron sobredrenado. Subsiguientemente se analizaron mediante un modelo estadístico explicativo multivariado aquellas variables demográficas, clínicas y terapéuticas implicadas en el mismo. En una segunda etapa se propone un protocolo rápido, sencillo y económico a fin de determinar la presión óptima dentro de cada caso en particular. Resultados: Dentro de los 56 pacientes incluidos, 32 pacientes (57%) presentaron sobredrenado; 10 pacientes (18%) presentaron higromas en imágenes postoperatorias, y de estos, 3 pacientes (5.4%) requirieron intervenciones quirúrgicas. El 94% de los sobredrenados ocurrieron a presiones menores o igual a 160 mmH20. Así mismo, 8 de los 11 pacientes con VDVP de presión fija media (100-110 mmH20) no regulable presentaron sobredrenado. En un 27% de los pacientes debió aumentarse la presión valvular como consecuencia de hallazgos clínicos o radiológicos de sobredrenado. Conclusión: Las hidrocefalias secundarias a patología tumoral presentan un comportamiento distinto al de las normotensivas. La tasa de sobredrenado en estos pacientes es superior y por consiguiente debe ser tenida en cuenta como una posible complicación relevante. Dada la heterogeneidad de tumores, cada paciente presenta presiones de LCR distintas y por ende debe individualizarse el tratamiento. Proponemos el uso del protocolo de medición intraquirúrgica de presión a fin de colocar la VDVP a la presión óptima para cada paciente, y evitar de esta manera el sobredrenado de LCR. Palabras clave. Hidrocefalia tumoral, presión valvular, sobredrenado, válvula ventrículo peritoneal. What is the optimal drainage pressure in obstructive tumors hydrocephalus? Analysis of factors underlying valve overdrainage, case review and development of surgical protocol ABSTRACT Background: Hydrocephalus is a common complication in CNS tumors pathology. The placement of ventriculoperitoneal shunt in these cases is, to date, the standard practice to treat this pathology and prevent the complications and comorbidities that it entails. At present, there is no protocol or initial valve pressure established for these patients, in whom we have observed a tendency toward overdrainage of cerebrospinal fluid (CSF). The objective of this work is to analyze our experience in the treatment of obstructive hydrocephalus secondary to tumor pathology, determine factors related to the occurrence of overdrainage, its therapeutic management and subsequently protocolize in a simple and economical way the placement of this type of prosthesis as well as identify a therapeutic pressure that reduces the risk of overdrainage. Methods: Monocentric, analytical, retrospective study of a cohort of patients operated on at our institution for obstructive hydrocephalus secondary to tumors, between the years 2013-2022. Medical records, images and surgical protocols were analyzed. Those patients who developed overdrainage were identified. Subsequently, the demographic, clinical and therapeutic variables involved in it were analyzed using a multivariate explanatory statistical model. In a second stage, a quick, simple, and economical protocol is proposed to determine the optimal pressure within each case. Results: Among the 56 patients included, 32 patients (57%) presented overdrainage; 10 patients (18%) presented hygromas on postoperative images, and of these, 3 patients (5.4%) required surgical interventions. 94% of overdrains occurred at pressures less than or equal to 160 mmH20. Likewise, 8 of the 11 patients with non-adjustable medium fixed pressure shunt (100-110 mmH20) presented overdrainage. In 27% of patients, valve pressure had to be increased because of clinical or radiological findings of overdrainage. Conclusion: Hydrocephalus secondary to tumors presents a different behavior than normotensive ones. The rate of overdrainage in these patients is higher and therefore must be considered as a possible relevant complication. Given the heterogeneity of tumors, each patient has different CSF pressures and therefore treatment must be individualized. We propose the use of the intrasurgical pressure measurement protocol to place the shunt at the optimal pressure for each patient, and thus avoid CSF overdrainage.
... Congenital hydrocephalus (HC) arises from an imbalance in cerebrospinal fluid (CSF) dynamics, resulting in increased CSF volume, influenced by ventricle and subarachnoid space dimensions [1]. Common causes of infant hydrocephaly encompass congenital malformations, intraventricular hemorrhages, neoplasms, infections, and age-specific factors [2]. At present, diagnosing fetal hydrocephalus involves intrauterine ultrasound, genetic testing, or postnatal assessment based on clinical signs, utilizing sonography, computed tomography (CT) scan, and/or magnetic resonance imaging (MRI). ...
... At present, diagnosing fetal hydrocephalus involves intrauterine ultrasound, genetic testing, or postnatal assessment based on clinical signs, utilizing sonography, computed tomography (CT) scan, and/or magnetic resonance imaging (MRI). CT and MRI become crucial for evaluating disease progression and management efficacy, as prenatal ultrasound cannot gauge intracranial pressure [1,2,3]. While hydrocephalus as a standalone condition is common, its co-occurrence with ulcerative colitis is exceptionally rare, warranting specialized attention due to the potential shared pathophysiology between the two conditions. ...
The coexistence of fetal hydrocephalus (HC) and ulcerative colitis (UC) within a single patient is exceptionally rare. This paper presents the case of a 4-year-old girl initially diagnosed with congenital hydrocephalus via in-utero ultrasonography at 20 weeks of gestation. Subsequent ventriculoperitoneal (VP) shunt placement was performed, and 3 years later, the patient was histologically and serologically diagnosed with ulcerative colitis. The synchronization of these distinct medical events in the same individual, particularly the interval between the treatments, represents an unprecedented occurrence not previously documented. The report details the patient’s recent presentation of recurrent bloody diarrhea and failure to thrive, which was effectively managed with oral prednisolone and sulfasalazine. Notably, the simultaneous manifestation of these conditions prompts consideration of potential contributing factors, including genetic markers such as interleukin 18 (IL 18), which have been linked to both disorders in existing literature. This case underscores the need for further research to elucidate the genetic and pathological markers, as well as predictors, which may underlie the concurrent occurrence of hydrocephalus and ulcerative colitis. Understanding these complexities could offer valuable insights into the intricate interplay of genetic and environmental factors in the development of such unique medical co-morbidities.
... In the case of IVH-cased hydrocephalus, a cranial US is performed right after birth, as the highest risk of bleeding is found within a week of birth [62]. A CT scan can also check for ventricular dilatation and CSF accumulation [63]. These tests are also used to distinguish communicating or non-communicating and compensated or arrested hydrocephalus [64]. ...
Neonatal hydrocephalus is a neurologic congenital condition where excess CSF accumulates in the brain's ventricles and aqueducts, causing increased intracranial pressure. Global rising rates of neonatal hydrocephalus call for a better understanding of the etiology and advancement of more modernized therapeutic approaches. Currently, causes of neonatal hydrocephalus are believed to be genetic or from acquired injuries. Socioeconomic factors and maternal comorbidities also affect the health outcomes of neonatal hydrocephalus patients. Evaluation of development, presence, and recovery from neonatal hydrocephalus are through brain imaging, physical examination, and history taking. Infants with the condition most experience little loss of neurological function, but a significant fraction also faces worsening morbidities and sudden fatality. The two major treatments for the condition are ventriculo-subgaleal shunt (VSGS) and endoscopic third ventriculostomy (ETV), and both carry high risks of perioperative complications. Nevertheless, the chosen therapy for each patient requires consideration of their health status, and more importantly, their informed decision. The patient should also be informed about postoperative management and the importance of regular follow-ups with their neurosurgeon and neurologist.
... 13,14 Hydrocephalus was determined according to the triad of hydrocephalus proposed by Zhang et al., including the presence of widening of the anterior horn in a round or convex shape, dilatation of the posterior temporal horn, and the presence of periventricular hypodense. 15 Based on the type of hydrocephalus listed in the table, the communicating type was much more than non-communicating hydrocephalus or the blockage above the IV ventricle. A study conducted by Harwood also found that 30% of non-communicating hydrocephalus subjects. ...
Hydrocephalus in children can inhibit child growth. However, if treated immediately, the patient will develop normal intelligence. In radiology, the most important problem is to detect hydrocephalus early. Currently, radiology examinations can detect hydrocephalus accurately with a CT scan to identify the presence of blockages and assess the degree. Skull radiography is used to assess the presence of advanced hydrocephalus. A comparison is carried out and assesses the relationship between hydrocephalus measurement on the ventricular and cranial index by scanogram. The study used a cross-sectional analytics design, using Picture Archiving and Communication System (PACS) data. There were 68 samples taken using consecutive sampling, obtaining ventricular index measurement results above 0.30, and patients under 12 years old. Spearman rank test showed a correlation between the ventricular index measurements and cranial index, with Spearman’s Rho (r) = 0.856 and p0.001 with linear equation Y= 2.973 + 0.005X. It revealed that the constant 2.973 indicated that if there is no B coefficient value, the participation value will be 2.973. Furthermore, regression coefficient X of 0.005 indicated that the participation value grows by 0.005 for every 1 addition of the B coefficient value with R2= 0.340.
