(Posted:09-Jul-2015)

Hydrocephalus may be due to obstruction of the CSF circulation.Obstruction within the ventricles is most common in the narrow channels of the third ventricle and aqeduct,may be caused by tumour or a congenital anomaly such as aqueduct stenosis. Diversion of cerebrospinal fluid by means of a shunt procedure between the ventricular system and the peritoneal cavity or right atrium may result in promt releif of symptoms in obstructive or communicating hydrocephalus. Causes of hydrocephalus: 1)Communicating: •Bacterial meningitis. •Sarcoidosis. •Subarachnoid heamorrhage. •Head injury. 2)Non-communicating: •Tumours. •Colloid cyst. •Cerebral abcess. •Cerebellar or brain-stem haematoma. Clinical features: Threr is a headeche,sometimes with transient diplopia and visual obstructions,but few others symptoms. Investigation: The CT is normal,with normal sized or small ventricles.Lumber puncture for confirmation of the raised CSF pressure and part of treatment.MR angiography or cerebral venography will exclude cerebral venous sinus thrombosis or stenosis of other cause. Management: Any precipitating condition should be sough,relevant medication should be withdrawn and a weight-reducing diet instigated,if indicated.The carbonic anhydrase inhibitor,acetazolamide,may help to lower intracranial pressure.Repeated lumber puncture can be considered but is often unacceptable to the patient.