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At least 19 recordsLinked to original sources
PubMed1994

[A new classification for congenital hydrocephalus [perspective classification of congenital hydrocephalus (PCCH)] and postnatal prognosis (Part 3). Neuronal maturation process and prognosis in neonatal hydrocephalus].

Seventy cases of neonatal hydrocephalus were analyzed regarding the prognosis using the newly developed concept, namely "Perspective Classification of Congenital Hydrocephalus [PCCH]". The results revealed that the prognosis of premature-neonatal hydrocephalus is not necessarily poor even in the early periods of the neuronal maturation (PCCH Stage- II/III). It was suggested that the major underlying pathophysiological difference between the premature-neonatal and fetal hydrocephalus in the same stage of neuronal maturation is the intracranial pressure dynamics. It was concluded that the fetal hydrocephalus should be treated in the early period of neuronal maturation as the form of neonatal hydrocephalus to avoid the insult of such high intracranial pressure dynamics in utero.

Fetal Diseases↗
PubMed1999

Acute hydrocephalus and chronic hydrocephalus with the need of postoperative shunting after aneurysmal subarachnoid hemorrhage.

During a 6-year period, 168 consecutive patients who presented with subarachnoid hemorrhage (SAH) and underwent surgical clipping of aneurysms were reviewed at a follow-up examination from 6 to 77 months (mean 38 months) after the ictus. Acute hydrocephalus was defined when the bicaudate index was greater than the 95th percentile for age on a computed tomographic scan within 72 hours of the hemorrhage. Forty (24%) patients developed acute hydrocephalus. The Hunt and Hess grades and Fisher's SAH grades at the time of admission, the presence of intraventricular hemorrhage and symptomatic cerebral vasospasm, and cerebrospinal fluid (CSF) diversion were found to be significantly associated with acute hydrocephalus. The overall mortality in this study was 16%. Of the 141 surviving patients, 20 (14%) patients underwent ventriculoperitoneal (VP) shunt replacement secondary to chronic hydrocephalus. In the present study, we found that the following factors were significantly related to the need of VP shunting: increasing age, the presence of acute hydrocephalus, preoperative CSF diversion, low admission Hunt and Hess grades, and poor Fisher's SAH grades. No patient was readmitted for shunt replacement at our hospital later than 117 days after hemorrhage. Acute hydrocephalus was combined with high mortality (28%) at our follow-up review. Ten of 29 (34%) patients with acute hydrocephalus required definite shunt replacement. However, less than 10% of patients without acute hydrocephalus needed shunting postoperatively. We recommend that patients with aneurysmal SAH should be followed up at least 6 months after the hemorrhage, especially in those patients with high risks of developing chronic hydrocephalus.

Acute Disease↗
PubMedDate not supplied

Association of deep white matter infarction with chronic communicating hydrocephalus: implications regarding the possible origin of normal-pressure hydrocephalus.

The coexistence of cerebrovascular disease leading to deep white matter infarction and normal-pressure hydrocephalus has been noted previously in clinical studies, as both diseases can present with the triad of gait disturbance, dementia, and incontinence. The purpose of this MR study was to determine if the two diseases demonstrated a statistical association. Evidence of patchy periventricular hyperintensity representing presumed deep white matter infarction was sought in 20 patients shunted for normal-pressure hydrocephalus and in 35 additional consecutive patients with clinical symptoms and MR findings consistent with normal-pressure hydrocephalus. Deep white matter infarction was also sought in 62 consecutive age-matched control subjects. There was a statistically significant (p less than .001) higher association (58%) of marked infarction in the 55 patients with normal-pressure hydrocephalus than in the age-matched controls (24%). MR findings of communicating hydrocephalus (ventriculomegaly and increased aqueductal CSF flow void) were sought in 78 consecutive patients with presumed deep white matter infarction, and the degree of severity of the two diseases was also found to be statistically significant (p less than .05). In view of this association, the possibility that the two diseases are related was considered. A potential mechanism is discussed whereby deep white matter infarction leading to decreased periventricular tensile strength could result in communicating hydrocephalus. It is plausible that normal-pressure hydrocephalus may result from a number of different insults to the brain.

Aged↗
PubMed1981

[Normal pressure hydrocephalus (NPH) following subarachnoid hemorrhage (SAH)-clinical consideration of CT and development of hydrocephalus after SAH (author's transl)].

CT scans were used to evaluate the development of the hydrocephalus, periventricular hypodensity (PVH) and the degree of the brain damage on 33 patients with the normal pressure hydrocephalus (NPH), following the subarachnoid hemorrhage (SAH), and the following conclusion can be drawn from our study. 1) NPH occurs in 33 cases out of 156 cases of subarachnoid hemorrhage (21%), and there was a relatively high incidence of normal pressure hydrocephalus following rupture of the anterior communicating artery aneurysm. 2) Factors causing NPH may be the arterial vasospasms and subarachnoid blood clot of the basal cistern verified by CT. 3) According to the repeated CT and lumbar tap after SAH, PVH, and, hydrocephalus usually become apparent around 7-10 days and most prominent around 3-4 weeks after SAH except for acute hydrocephalus appeared immediately after severe SAH. 4) The results were compared with CT findings and clinical response to shunting. The clinical improvements were achieved in cases (85%), in which CT showed PVH, small brain damage in the frontal lobe due to vasospasms or intracerebral hematoma, and no cortical atrophy. 5) Repeated CT can give better informations on the development of hydrocephalus in cases of SAH and can provide the indication for a shunt.

Adult↗
PubMed1990

Late hydrocephalus after arrest and resolution of neonatal post-hemorrhagic hydrocephalus.

This report describes the occurrence of rapid progression of hydrocephalus after discharge from the nursery in four of 48 infants who had had previous arrest of progression of post-hemorrhagic hydrocephalus, and at least partial resolution of ventriculomegaly. This later-onset hydrocephalus occurred at a mean age of seven months; the most consistent presenting clinical feature was rapid head growth. Three of the four infants required a ventriculo-peritoneal shunt and the fourth was treated with acetazolamide, with apparent resolution of the hydrocephalus. Newborn infants with post-hemorrhagic hydrocephalus should be followed carefully throughout the first year for prompt detection of later hydrocephalus.

Cephalometry↗
PubMed1991

Hydromyelic hydrocephalus. Correlation of hydromyelia with various stages of hydrocephalus in postshunt isolated compartments.

The clinical features and pathophysiology of specific forms of hydromyelia are analyzed in this report together with the chronological changes of associated hydrocephalus. Nine patients were studied; all had hydromyelia with varying degrees of associated hydrocephalus. Clinically applicable classification systems were used to evaluate the progression of hydrocephalus (Stages I to IV) and to define the compartment isolated after shunting in the previously communicating cerebral ventricles (Types I to IV). Four patients had Stage IV disease (holoneural canal dilatation); one had Stage II and four had Stage I disease (both Stages I and II with supratentorial hydrocephalus). All patients were initially treated by ventriculoperitoneal shunting at an average age of 9.9 years. Five patients had progressive spinal symptoms before or after treatment of their hydrocephalus. Two patients had Type III isolation (an isolated rhombencephalic ventricle) with a functioning ventricular shunt; ventriculography confirmed a communication between the fourth ventricle and the hydromyelia, and both patients improved after placement of a shunt in the fourth ventricle. The remaining patients had Type IV isolation (isolated central canal dilatation) with a functioning ventricular shunt. This study indicates that in some cases the pathophysiology of hydromyelia is closely related to associated hydrocephalus. A new concept of the development of an isolated compartment after shunting is proposed to explain the progression of hydromyelia in these cases.

Adolescent↗
PubMed1990

Hydrocephalus--revision of its definition and classification with special reference to "intractable infantile hydrocephalus".

With the advent of computed tomography (CT) scan, much information has been obtained about the pathophysiology of hydrocephalus. It is now clear that hydrocephalus is not a disease entity but rather a syndrome or sign resulting from disturbances in the dynamics of cerebralspinal fluid (CSF) caused by various diseases. Consequently, it has become necessary to revise its definition and classification. In this paper, a contemporary definition and classification of hydrocephalus are presented. Also, a classification of "intractable hydrocephalus"--with its diagnostic criteria--which is a clinically unsolved problem, is attempted, bearing in mind its place in the clinical management and future investigation of the pathophysiology of hydrocephalus.

Humans↗
PubMed1983

Correction of congenital hydrocephalus in utero I. The model: intracisternal kaolin produces hydrocephalus in fetal lambs and rhesus monkeys.

In the fetus with congenital hydrocephalus, obstruction to the flow of cerebrospinal fluid (CSF) results in ventricular dilation and neurologic impairment. Decompression of the obstructed ventricles before birth may ameliorate the damage and allow normal development to proceed. Although appealing, this pathophysiologic rationale has not been adequately tested because a satisfactory fetal model has not been available. We have developed a model of obstructive hydrocephalus in the fetal lamb and rhesus monkey by injecting kaolin into the cisterna magna through the posterior atlanto-occipital membrane early in the last trimester. Preliminary studies injecting silicone oil were unsuccessful. The development of fetal ventriculomegaly was followed using prenatal ultrasonography. Massive hydrocephalus developed in six sheep, three liveborn at term and three stillborn after premature vaginal delivery, and in 2 fetal rhesus monkeys. All treated animals had external signs of hydrocephalus with marked cranial enlargement. Neuropathologic examinations demonstrated fibrosis of the leptomeninges and subarachnoid spaces around the fourth ventricle. Dilation of the lateral and third ventricles resulted, with attenuation of the cerebral white matter. On histologic examination, the grey matter was relatively well preserved, while the white matter was severely attenuated. This model mimics the clinical and pathologic picture seen in human infants and should allow us to study the pathophysiology of congenital obstructive hydrocephalus and the efficacy and feasibility of its correction in utero.

Animals↗
PubMed1987

Inherited hydrocephalus in Csk: Wistar-Imamichi rats; Hyd strain: a new disease model for hydrocephalus.

Hydrocephalic rats were found in a breeding colony of Csk: Wistar-Imamichi strain rats. In males, the hydrocephalus were serious and could be detected from 7 days after birth. Survival was 3-4 weeks. In females, the hydrocephalus was moderate, there was no abnormal external appearance, and the rats were able to mature. Ventricular dilatation was excessive in males but moderate in females. The total frequency of hydrocephalus was 34.3% in both males and females. Breeding data indicated that this disease is heritable and is single dominant and X-linked (symbol, Hyd). The female moderate hydrocephalics could be detected by progeny tests without examining brain sections. No evidence of developmental anomaly was observed in the ventricles. This hydrocephalus was classified as being of the communicating type, and this strain was named the Hyd strain as an animal model for human hydrocephalus.

Animals↗
PubMed1976

Experimental congenital hydrocephalus. A review with special consideration of hydrocephalus produced by zinc deficiency.

A review was made of experimental methods available to produce congenital hydrocephalus by teratogenic methods. Radiation, infections, trypan blue, hypervitaminosis A, salicylates and nutritional deficiencies were considered. In the course of prenatal zinc deficiency experiments, congenital hydrocephalus was frequently encountered and histologic sections were made of many representative specimens. Details of the findings are described, among them various types of aqueduct stenosis or obileration. Although these anomalies suggest that occlusion of the aqueduct is the cause of the enlargement of the ventricular system it was noted that there was also ventricular dilatation caudal to the stenotic point of the aqueduct. Hydrocephalus without aqueductal stenosis has also been observed in experimental animals. It seems possible that some cases of congenital hydrocephalus attributed to aqueductal stenosis are examples of hydrocephalus with secondary block of the aqueduct.

Animals↗
PubMed1979

Acquired hydrocephalus. I. A clinical analysis of 160 patients studied for hydrocephalus.

A total of 160 patients suspected of having acquired hydrocephalus were studied either by quantitative isotope ventriculography (QIV) or by lumbar isotope cisternography (LIC). Of these patients, 56 had hydrocephalus. Mental deterioration, gait disturbances, ataxia, spasticity, and incontinence were most frequently present in the hydrocephalic patients, but none of the signs or combinations thereof are pathognomonic of acquired hydrocephalus. These signs are independent of the intracranial pressure (ICP) and the type of hydrocephalus. Surgical shunt procedures were in most cases followed by the disappearance of mental deterioration, gait disturbances, ataxia, and spasticity.

Adolescent↗
PubMed1976

The physics of the cranial cavity, hydrocephalus and normal pressure hydrocephalus: mechanical interpretation and mathematical model.

It is intended for this research, to provide some basis for the understanding of the rational mechanics of the cranial content. There are many interesting and controversial facts derived from the experimental and clinical-pathological observations of hydrocephalus and increased intracranial pressure. For instance, in some patients a moderate increase of intracranial pressure is accompanied by hydrocephalus and mental changes, while in others, with high intracranial pressure, the ventricles and mental functions remain unaltered. What then is the parameter that changes the size of the ventricles and impairs brain function? It is shown how the transmission of intraventricular pressure throughout the brain parenchyma creates a stress distribution that varies in magnitude; how during the production, maintenance, and reversal of hydrocephalus, and normal pressure hydrocephalus the stress is distributed throughout the brain; and how in the presence of a sudden increase of intracranial pressure nature has arranged additional mechanisms for protecting the brain. It is important to recognize that some aspects of intracranial physiopathology can be explained through classical concepts of physics, prior to attempting to interpret such processes solely in terms of biological or auto-regulatory phenomena.

Adult↗
PubMed1978

External hydrocephalus. Early finding in congenital communicating hydrocephalus.

Dilation of the subarachnoid channels overlying the cerebral hemispheres, ie, external hydrocephalus, can be an early anatomic-radiologic finding in some infants with congenital communicating hydrocephalus. This structural change may progress to ventricular dilation or internal hydrocephalus. Enlargement of the subarachnoid channels appears to occur during the first stage in the development of congenital communicating hydrocephalus, which is to say that the subarachnoid compartment allows accumulation of CSF before there is significant ventricular distention, at least in some infants. When a pneumoencephalogram or a CT scan is performed at this stage, the findings may falsely suggest "cerebral atrophy." In six patients who received this grave neuroradiologic diagnosis, five subsequently developed normally and the sixth has static incoordination or clumsiness and mild intellectual deficiency.

Humans↗
PubMed1986

Alloimmune neonatal thrombocytopenia and hydrocephalus. Platelet antigen Zwa, ABO-antigens and HLA-antigens in mothers to infants with hydrocephalus.

In 27 mothers to infants with hydrocephalus determinations of platelet antigen Zwa, HLA-typing and ABO-typing were performed in order to evaluate whether undiagnosed alloimmune neonatal thrombocytopenia (AINT) could be an aetiological factor in hydrocephalus. All mothers were Zwa-positive, and the frequency of HLA-antigens and ABO-antigens was as in the normal population. Though sporadic cases of hydrocephalus following AINT are reported, this is not a common cause of intracranial haemorrhage and hydrocephalus.

ABO Blood-Group System↗
PubMed2001

[Update on diagnosis and treatment of normotensive hydrocephalus (chronic hydrocephalus of the adult)].

Normal pressure hydrocephalus, or adult chronic hydrocephalus, is a relatively unknown entity. Classically, this disease is characterized by progressive dementia, gait disturbance, and urinary incontinence. Despite an increase in the prevalence of this type of dementia due to longer life expectancy, its diagnosis and treatment remain controversial. Recent studies have reported that the percentage of patients who show clinical improvement after shunting is still low and that the complication rate is excessively high. However, our experience and that of other authors indicates that the percentage of improvement after shunting can be greater than 80% and the complication rate can be low if a strict diagnostic protocol is applied and if the most appropriate valve is selected, based on the hydrodynamic characteristics of the shunt. The aim of this review is to provide an update of the clinical features, diagnosis and treatment of adult chronic hydrocephalus. We also discuss the diagnostic and treatment protocols applied in our centre in patients with suspected adult chronic hydrocephalus.

Adult↗
PubMed2001

[Incidence of surgery for hydrocephalus in adults surveyed: same number afflicted by hydrocephalus as by multiple sclerosis].

The incidence of surgical treatment for adult hydrocephalus (older than 18 years) in Sweden from 1996 to 1998 was surveyed. The number of operations was 891 and the average incidence 3.36 operations per 100,000 inhabitants and year, varying regionally from 2.3 to 6.3. The mean age was 60 years (range 18-92), with no sex difference. Normal pressure hydrocephalus (47%) was most common, followed by communicating high pressure hydrocephalus (27%) and aqueductal stenosis (11%). 804 shunt operations (90%) and 67 ventriculostomies (7.5%) were performed, 2% were unclassified.

Adult↗
PubMed1978

[Normal pressure hydrocephalus. Part 1. Dynamic study of CSF circulation in patients with normal pressure hydrocephalus (author's transl)].

To clarify the pathogenesis of normal pressure hydrocephalus (NPH), quantitative measurement of CSF dynamics was attempted using RI techniques. In this study results concerning RI ventriculography and RI transfer test from CSF to plasma were reported. "Barrier ratio" and regional cerebral blood flow study in NPH will be reported elsewhere. Fifty-three patients with chronic communicating hydrocephalus wer devided into two groups. Thus, twenty-seven cases were diagnosed as NPH according to clinical symptoms and signs, and others were considered as mere chronic communicating hydrocephalus without any NPH characteristics. Results are as follows: 1) 169Yb--DTPA ventriculography; In NPH group, there was longer retention of RI injected into lateral ventricle, and RI activity was not detected in the cisterna magna 60 minutes after the injection. These findings show remarkable delay of CSF flow in NPH patients. 2) Transfer test of 169Yb--DTPA from CSF to plasma; Immediately after the RI injection, Transfer ratio of RI activity from CSF to plasma was measured. It was revealed that intraventricular RI was more rapidly transfered to plasma in NPH group compared with in the control group, suggesting accelerated trans-ependymal absorption of RI in NPH group.

Aged↗