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HYDROCEPHALUS Dr  Rakesh HYDROCEPHALUS Dr  Rakesh

HYDROCEPHALUS Dr Rakesh - PowerPoint Presentation

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Uploaded On 2022-05-18

HYDROCEPHALUS Dr Rakesh - PPT Presentation

Nagar Assistant Professor PG department of Kaumarbhritya National Institute of Ayurveda Jaipur  जलशरषक   जलशरषक  Described in Bhaisajya Ratnawali 98 ID: 911931

hydrocephalus csf accumulation ventricle csf hydrocephalus ventricle accumulation foramen head sign prominent cerebrospinal flow fluid brain skull aqueductal side

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Presentation Transcript

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HYDROCEPHALUS

Dr Rakesh NagarAssistant ProfessorP.G. department of KaumarbhrityaNational Institute of Ayurveda, Jaipur

 जलशीर्षक 

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 जलशीर्षक 

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Described in Bhaisajya Ratnawali 98th chapter

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जलशीर्षक निदान

दुष्ट अम्बु पानातअति शैत्यतो आन्त्र कृमे उद्भवतोअभिघातात

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असात्मय भोजन अशनतः

 सुरायाः अत्यर्थः पानातपवन प्रदोषातदन्तोद्गमे

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HYDROCEPHALUS

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Hydrocephalus word is derrived from two greek words Hydro = WaterCephalus = Head

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Definition

Hydrocephalus is an abnormal accumulation of cerebrospinal fluid or CSF within the ventricle of the brain.Normal CSF production 20ml/hrTotal CSF in infant 50mlTotal CSF in adult 150ml

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CEREBROSPINAL FLUID CIRCULATION

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CHOROID PLEXUS

LATERAL VENTRICLESINTRAVENTRICULAR FORAMEN OF MUNRO

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THIRD VENTRICLE

CEREBRAL AQUEDUCT OF SYLVIUSFOURTH VENTRICLE

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02

LATERAL FORAMINAS OF LUSCHKA01MEDIAL FORAMEN OF MAGENDIE

CENTRAL CANAL

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SUBARACHNOID SPACE

ARACHNOID GRANULATIONS

DURAL SINUS

VENOUS DRAINAGE

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Why this excessive accumulation of CSF occurs ?

The accumulation of CSF is due to eitherIncreased ProductionObstruction in the flow of cerebrospinal fluid

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Etiology Congenital

Acquired

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Congenital hydrocephalusCSF flow obstruction

Aqueductal stenosisArnold chiari malformationDandy walker malformationIntrauterine infectionsIntracranial bleedsCongenital tumors

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X linked inherited disorder or by intrauterine infections

Aqueductal stenosis

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Arnold chiari malformation

Elongation and downward displacement of cerebellum or brain stem --- hamper the CSF flow

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Dandy walker syndrome

Cystic malformation of cerebellum and 4th ventricle, which occurs due to atresia of the foramen of Luschka and Magendie.

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Acquired HydrocephalusPost meningitis

Tubercular meningitisChronic or acute menigitisPosterior fossa tumours

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Clinical features

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Increased head size with prominent forehead

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Sutures and fontanel remain unduly prominent with delayed closure

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Prominent scalp veins

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Setting Sun sign

Impaired upward gaze so as there will be visible sclera above the iris

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Pressure sign

Cranial nerve palsiesProjectile vomitingSevere headache

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Diagnosis

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Clinical featuresSerial measurement of Head circumference

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MACEWEN’S SIGN

Percussing on the skull of the patient and a cracked pot sound can be heard to the naked ears of the examiner brought closed to the skull.sound can be heard even better if percussion is done on one side while a stethoscope is placed on the other side. A positive test is indicative of separated sutures.

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Management

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Medicinal care

Acetazolamide – carbonic anhydrase inhibitorDecreases CSF secretionDiuretics

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Surgical care

Preferred therapeutic optionShunting Ventriculoperitoneal shuntingVentriculoatrial shunting

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