Hydrocephalus in adults chapter 7

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mbrieger
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110915
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Hydrocephalus in adults chapter 7
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2011-10-21 12:40:18
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Hydrocephalus adults chapter
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Hydrocephalus in adults chapter 7
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  1. classifications of HCP
    • acute vs. chronic
    • compensated vs. uncompensated
    • normal pressure vs. high pressure
    • communicating vs. obstructive
  2. active, compensated or arrested referst o
    whether hydrocephalus is still producing symptoms
  3. normal pressure vs. high pressure refers to
    CSF pressure
  4. communicating vs. noncommunicating
    are ventricles communicating with aubarachnoid space
  5. obstructive vs. nonobstructive
    is there a block
  6. causes of noncommunicating HCP
    • tumors or cysts of ventricular system
    • Aqueductal stenosis
    • Posterior fossa mlformations, including tumors
    • pagets disease
  7. causes of communcating hydrocephalus
    • trauma
    • SAH
    • Infx
    • Idiopathic
    • SDH
    • extraaxial tumors
  8. s/s of acute HCP
    • HA
    • Vomiting
    • Papilledema
    • Drowsiness
    • Ataxia
  9. s/s of chronic HCP
    • gait disorder
    • memory loss
  10. nonspecific s/s of HCP
    • urinary incontiinence
    • slowing of thought and action
  11. work up for suspected high-pressure HCP
    • CT or MRI (better if only one).
    • lumbar puncture in communicating HCP only
  12. types of shunt
    • VP shunt - ventriculoperitoneal shunt
    • VA shunt - ventriculoatrail shunt
    • Ventricularpleural shunt
    • Lumboperitoneal shunt (for C HCP only)
  13. complications of shunting
    • SDH
    • Failure of ventricles to shrink
    • infx
    • shunt obstruction
    • overdrainage and slit ventricle syndrome
    • disconnection of shunt components
    • Perforation of hollow viscus by the peritoneal catheter
  14. success rate for shunts
    complication rate
    70%


    20%
  15. consequence of overdraining
    • HA
    • possible development of SDH
  16. insufficient drainage
    results in..
    caused by..
    • failure of ventricles to shrink
    • mismatch valve pressure to ventricular pressure
  17. consequence of shunt malfunction
    failure of ventricles to shrink
  18. shunt malfunctions
    • valve malfunction
    • plugging of ventricular catheter with chorid plexus or other
    • peritoneal catheter dysfunction
  19. may indictate if a shunt is malfunctioning
    telesensor
  20. shunt infection pathogen example
    • staphlycoccus epidermidids
    • diphtheroids
  21. shunt infection diagnosis
    tap shunt
  22. treatment of shunt infx
    removal and replacement of shunt

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