A 12dayold boy, first born to a nonconsanguineous indian couple, presented with a history of antenatally diagnosed hydrocephalus during ultrasound at 32 weeks. We describe a patient with intraventricular hemorrhage ivh who experienced the delayed development of acute transient hydrocephalus. Acute transient obstructive hydrocephalus is rare in adults. In these cases, brain tissues around the ventricles shrink, and the ventricles are. In fact, metastasis to the pineal region has been estimated to account for only 0. Obstructive hydrocephalus results from a mechanical. One of the most common causes of hydrocephalus is aqueductal stenosis. Obstructive hydrocephalus radiology reference article. Metastatic disease to periventricular brain tissue can obstruct the flow of cerebrospinal fluid csf produced in the ventricles to the subarachnoid space where it is normally absorbed by arachnoid granulations. In babies, it may be seen as a rapid increase in head size. Obstructive hydrocephalus is a term usually used to denote obstructive noncommunicating hydrocephalus it is actually a term that causes confusion as used in the above sense implies that communicating hydrocephalus does not have an obstruction to csf flow absorption. In such a case one has to deal with a closed infection of the cerebral. Our purpose was to establish the frequency of this finding in shunted patients and attempt to elucidate its cause and clinical significance. Rarer still is a favorable outcome when such a condition supervenes.
This is the most common form of hydrocephalus in children and is almost always associated with increased. Here we present the case of an individual with signs and symptoms of obstructive hydrocephalus who was ultimately found to have. Figure 1 is an example of noncommunicating, obstructive hydrocephalus of the lateral ventricles arrows secondary to a pituitary neoplasm arrowhead obstructing the ventral aspect of the third ventricle. Cureus idiopathic intracranial hypertension masking as. Unlike communicating hydrocephalus, which dandy felt he could not adequately explain, obstructive hydrocephalus. Obstructive hydrocephalus is broadly defined as an abnormal accumulation of csf in the brain due to obstruction of csf flow 1 2 3. Evelyn stewart, md ca, b, a department of psychiatry, university of british columbia, vancouver, british columbia, canada. This typically causes increased pressure inside the skull. We describe three cases of a syndrome in which obstruction of the trigone of the lateral ventricle seals off the temporal horn from the rest of the ventricular. Neuroimaging revealed elongated and tortuous basilar artery indenting and elevating the floor of third ventricle causing obstructive hydrocephalus. We present the case of an 11 yearold boy with a previous history of obsessivecompulsive disorder ocd, who experienced a dramatic and acute worsening of ocd symptoms in temporal association with obstructive hydrocephalus secondary to a tectal lowgrade glioma. Approximately 55% of all hydrocephalus are congenital.
We report a patient who presented with acute confusion and vomiting. Although this book was originally written for parents, it contains basic information about hydrocephalus that is valuable to everyoneparents of children with hydrocephalus, families and individuals. Obstructive hydrocephalus also called noncommunicating hydrocephalus is a form of hydrocephalus which is caused by some visible blockage in the flow of cerebrospinal fluid. Hydrocephalus fact sheet national institute of neurological. Obstructive hydrocephalus an overview sciencedirect topics. Endoscopic third ventriculostomy etv, as an alternative to conventional ventriculoperitoneal vpventriculoatrial va shunting, is a firmly established treatment for hydrocephalus 5,9,15,19. In patients with ivh, acute obstructive hydrocephalus can develop at any time after the ictus. Guy mckhann aims to educate others about its diagnosis and treatment.
Here the diagnosis of obstructive hydrocephalus was established on the basis of neuroimaging, showing dilation of. Accurate diagnosis is imperative as ongoing advancements in treatment can yield dramatic positive results. The condition refers to abnormal col lections of csf over the hemispheres and is a form of communicating hydrocephalus. Communicating hydrocephalus occurs when the flow of csf is blocked after it exits the ventricles. Hydrocephalus may also be communicating or non communicating. Get a printable copy pdf file of the complete article 251k, or click on a page image below to browse page by page. Hydrocephalus causes transependymal resorption of spinal fluid that in turn produces periventricular interstitial edema. Department of neurosurgery, medical university of south carolina, charleston, sc hydrocephalus is a neurologic condition that requires lifelong vigilance by various health care professionals.
Pediatric obsessivecompulsive disorder exacerbation and obstructive hydrocephalus. Cerebrospinal fluid and hydrocephalus moffitt cancer center. There is no doubt that bulk csf flow occurs within and. This study was performed to determine if diffusion imaging can demonstrate this interstitial edema in the periventricular region in patients with obstructive hydrocephalus and if it can be used to assess the treatment response. Links to pubmed are also available for selected references. This procedure is known as an endoscopic third ventriculostomy. Download fulltext pdf download fulltext pdf management of obstructive hydrocephalus in pregnant patient article pdf available october 2015 with 598 reads. Hydrocephalus exvacuo results from brain damage caused by stroke or injury.
The first cases of systemic lupus erythematosus sle with effects on the nervous system were reported more than 100 years ago. This article is from journal of clinical neurology seoul, korea, volume 9. Obstructive hydrocephalus pacific adult hydrocephalus center. The acquired form may follow meningitis or another cerebral inflammation or tumor. Though a delayed presentation of acute but transient obstructive hydrocephalus is unusual, it is important to be aware of this scenario and ensure that deterioration secondary to thrombus migration and subsequent obstructive hydrocephalus do not occur. Metastasis to the brain occurs in 20%40% of cancer patients. Pdf the three major clinical manifestations of spina bifida hydrocephalus, paraplegia and urinary and. Infants commonly present with progressive macrocephaly whereas children older than 2 years. Cerebellar involvement and obstructive hydrocephalus are rarely encountered in patients with sle. Noncommunicating hydrocephalus happens when the flow of csf is blocked along one or more of the narrow passages connecting the ventricles. Diffusion imaging in obstructive hydrocephalus american. Hydrocephalus in a rat model of meckel gruber syndrome.
This form is called communicating because the csf can still flow between the ventricles, which remain open. Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid csf occurs within the brain. More recently, it was suggested that the applications might. Giant trigeminal schwannoma presenting with obstructive.
Selection of the appropriate management strategy requires an understanding of the tumors natural history and treatment outcomes. Hydrocephalus is a condition caused by abnormal flow andor reabsorption of the cerebrospinal fluid, the waterlike liquid that surrounds the brain and spinal cord and. Obstructive hydrocephalus hydrocephalus noncommunicating. Obstructive hydrocephalus is present in 70% to 90% of patients with posterior fossa tumors at diagnosis.
This report describes the case of a 36yearold male who presented with a threemonth history of progressive headaches, dizziness, loss. After ct and mri of the head had shown ventriculomegaly figures 1a and 2, the patient was referred to the neurosurgical department for further evaluation. Management and resolution of the hydrocephalus was temporally associated with an improvement in his ocd compulsion symptoms. Obstructive hydrocephalus obstructive hydrocephalus also called noncommunicating hydrocephalus refers to excess accumulation of cerebrospinal fluid csf due to structural blockage of csf flow within the ventricular system. Obstructive hydrocephalus and facial nerve palsy secondary. While there is no known way to prevent hydrocephalus, many children with hydrocephalus can have great outcomes with appropriate treatment. Isolated pineal region metastasis from lung adenocarcinoma. Pediatric obsessivecompulsive disorder exacerbation and. Antenatal period was uneventful, and the child was born at 37 weeks early term by spontaneous normal vaginal delivery with apgar scores of 8 and 9. All patients with hydrocephalus shunted between 1989 and. Although the brain is one of the most common sites of metastasis from lung cancer, metastasis to the pineal region is rather rare. Hydrocephalus in a rat model of meckel gruber syndrome with a. Hydrocephalus is a lifelong condition and affects more than one million people in the united states.
Symptomatic hydrocephalus due to vertebrobasilar dolichoectasia is a rare occurrence. Obstructive hydrocephalus is reported in 70% to 80% of children with posterior fossa tumors and is frequently the cause of clinical deterioration at the time of diagnosis. Rarely, a third type of hydrocephalus caused by excessive csf production can be seen in patients with a choroid plexus tumor. The obstruction can occur at virtually any point of the csf pathway, including the ventricular system the lateral, 3rd and 4th ventricle, as well as the foramen of monroe and the sylvian aqueduct and the subarachnoid space, and numerous etiologies have been. This type may also be subclassified into congenital and acquired. Obstructive hydrocephalus definition of obstructive. Chiari malformation type ii icd10cm diagnosis code q07. A sound rationale for the treatment of nonobstructive communicating hydrocephalus by extirpation of the choroid plexuses from the cerebral ventricles was first advanced by dandy 1 in 1918 the original operative technic proposed by dandy to accomplish this end was essentially an open operation, in the sense that the cerebrospinal fluid was first evacuated from the two lateral ventricles. In many patients, this is a durable treatment and forgoes the need for a ventriculoperitoneal shunt. The initial use of etv was to create an alternate orifice for cerebrospinal fluid csf egress, to treat obstructive hydrocephalus 18,24. Obstructive hydrocephalus article about obstructive. Hydrocephalus in children kristopher t kahle, abhaya v kulkarni, david d limbrick jr, benjamin c warf hydrocephalus is a common disorder of cerebral spinal.
Intraventricular haemorrhage and obstructive hydrocephalus. Non communicating hydrocephalus also called obstructive. Pdf management of obstructive hydrocephalus in pregnant. The first patient presented with significant headache at time of sle diagnosis and negative brain imaging. Congenital hydrocephalus is most often first recognized at an early age and most commonly occurs in small and toy breed dogs. We report two patients with sle who developed cerebellar ataxia. A case report aldrich leung, md, a clare bleakley, mbbs, b adrian loh, mbbs, a, b kelly saran, md, b s. Initially, the patient was treated with antipsychotics olanzapine and aripiprazole for her psychotic symptoms. This case demonstrates the incidental finding of a chiari i malformation with obstructive hydrocephalus, in a patient initially worked up for a pituitary tumor. Obstructive hydrocephalus occurring during the course of meningococcic meningitis is quite unusual today with the present methods of diagnosis and treatment. A guide for standardizing terminology in toxicologic pathology for rodents. Noncommunicating hydrocephalus also called obstructive. Emerging insights and new perspectives on the nature of.
Few reports have documented signal abnormalities within the corpus callosum on mr studies obtained after ventricular decompression in patients with hydrocephalus. Adult hydrocephalus is one of the only reversible causes of dementia. Cerebellar ataxia and obstructive hydrocephalus, rare. Chiari i malformation is a congenital hindbrain dysgenesis characterized by caudal displacement of the cerebellar tonsils below the foramen magnum, and into the spinal canal 12. A usually congenital condition in which an abnormal accumulation of fluid in the cerebral ventricles causes. Full text full text is available as a scanned copy of the original print version. Magnetic resonance imaging mri showed multiple infiltrative masses in both cerebral and cerebellar hemispheres.