Nagar Assistant Professor PG department of Kaumarbhritya National Institute of Ayurveda Jaipur जलशरषक जलशरषक Described in Bhaisajya Ratnawali 98 ID: 911931
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HYDROCEPHALUS
Dr Rakesh NagarAssistant ProfessorP.G. department of KaumarbhrityaNational Institute of Ayurveda, Jaipur
जलशीर्षक
Slide2Slide3Slide4जलशीर्षक
Slide5Described in Bhaisajya Ratnawali 98th chapter
Slide6जलशीर्षक निदान
दुष्ट अम्बु पानातअति शैत्यतो आन्त्र कृमे उद्भवतोअभिघातात
Slide7असात्मय भोजन अशनतः
सुरायाः अत्यर्थः पानातपवन प्रदोषातदन्तोद्गमे
Slide8HYDROCEPHALUS
Slide9Hydrocephalus word is derrived from two greek words Hydro = WaterCephalus = Head
Slide10Definition
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
Slide11CEREBROSPINAL FLUID CIRCULATION
Slide12CHOROID PLEXUS
LATERAL VENTRICLESINTRAVENTRICULAR FORAMEN OF MUNRO
Slide13THIRD VENTRICLE
CEREBRAL AQUEDUCT OF SYLVIUSFOURTH VENTRICLE
Slide1402
LATERAL FORAMINAS OF LUSCHKA01MEDIAL FORAMEN OF MAGENDIE
CENTRAL CANAL
Slide15SUBARACHNOID SPACE
ARACHNOID GRANULATIONS
DURAL SINUS
VENOUS DRAINAGE
Slide16Slide17Slide18Slide19Why this excessive accumulation of CSF occurs ?
The accumulation of CSF is due to eitherIncreased ProductionObstruction in the flow of cerebrospinal fluid
Slide20Etiology Congenital
Acquired
Slide21Congenital hydrocephalusCSF flow obstruction
Aqueductal stenosisArnold chiari malformationDandy walker malformationIntrauterine infectionsIntracranial bleedsCongenital tumors
Slide22X linked inherited disorder or by intrauterine infections
Aqueductal stenosis
Slide23Arnold chiari malformation
Elongation and downward displacement of cerebellum or brain stem --- hamper the CSF flow
Slide24Dandy walker syndrome
Cystic malformation of cerebellum and 4th ventricle, which occurs due to atresia of the foramen of Luschka and Magendie.
Slide25Acquired HydrocephalusPost meningitis
Tubercular meningitisChronic or acute menigitisPosterior fossa tumours
Slide26Clinical features
Slide27Increased head size with prominent forehead
Slide28Sutures and fontanel remain unduly prominent with delayed closure
Slide29Prominent scalp veins
Slide30Setting Sun sign
Impaired upward gaze so as there will be visible sclera above the iris
Slide31Pressure sign
Cranial nerve palsiesProjectile vomitingSevere headache
Slide32Slide33Diagnosis
Slide34Clinical featuresSerial measurement of Head circumference
Slide35MACEWEN’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.
Slide36Management
Slide37Medicinal care
Acetazolamide – carbonic anhydrase inhibitorDecreases CSF secretionDiuretics
Slide38Surgical care
Preferred therapeutic optionShunting Ventriculoperitoneal shuntingVentriculoatrial shunting
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