adult congenital hydrocephalus

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1、September12,2002AdultCongenitalHydrocephalusRamanaRamanaYedavalli,UniversityofIllinoisCollegeofMedicine,YearIVGillianLieberman,MDObjectivesObjectivesRamanaYedavalliGillianLieberman,MDDiscussnormalCSFflowmechanicsDiscussnormalradiographicfindingsDiscussepidemiologyofhydrocephalusDiscus

2、sbrieflytheetiologiesofhydrocephalusDiscusspathologyandpathophysiologyassociatedwithhydrocephaluswithemphasisonadultclinicalpresentationDiscussclinicalcaseandradiographicfindings2IntroductionRamanaYedavalliGillianLieberman,MD““WaterontheBrainWaterontheBrain””AbnormalaccumulationofCSFi

3、nthecranialAbnormalaccumulationofCSFinthecranialvaultvaultCSFgenerallyproducedatanaveragerateofCSFgenerallyproducedatanaveragerateof~0.3mL/min.Tomaintainsteadystate,rateof~0.3mL/min.Tomaintainsteadystate,rateofCSFproductionmustnecessarilyequalrateofCSFproductionmustnecessarilyequalrateof

4、CSFoutflowCSFoutflow3IntroductionRamanaYedavalliGillianLieberman,MDTwogeneralcauses:ObstructionofoutflowofCSF(common)OverproductionofCSF(usuallyduetochoroidplexuspapillomapapilloma––rare--lessthan0.5%ofcases)TwocategoriesofobstructivehydrocephalusCommunicatingNoncommunicatingEtiolo

5、giescanbecongenitaloracquired4IntroductionRamanaYedavalliGillianLieberman,MDCommunicatinghydrocephalus––resultswhentheobstructiontooutflowisdistaltotheforaminaofMagendieMagendieandLuschkaAllventriclesareenlargedObstructionisusuallyatthelevelofthearachnoidarachnoidgranulationsCausescan

6、includeintraventricularintraventricularhemorrhage,meningealmeningealscarring,amongothers.Noncommunicatingmunicatinghydrocephalus––resultswhentheobstructiontooutflowisproximaltothefourthventricleforaminaVentricle(s)proximaltotheobstructionareenlargedVentricle(s)distaltotheobstructionare

7、generallynormalinsizeObstructioncanbecongenitaloracquired5VentricularSystemRamanaYedavalliGillianLieberman,MDAdaptedfrom:Netter,F.H.:AtlasofHumanAnatomy,2ndnded.ed.EastHanover,NewJersey:Novartis,19976CSFCirculationPathwaysRamanaYedavalliGillianLieberman,MDAdaptedfr