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Hydrocephalus

Authors
Abilash Haridas, MD
Tadanori Tomita, MD
Section Editors
Marc C Patterson, MD, FRACP
Leonard E Weisman, MD
Deputy Editor
Carrie Armsby, MD, MPH

INTRODUCTION

Hydrocephalus is a disorder in which an excessive amount of cerebrospinal fluid (CSF) accumulates within the cerebral ventricles and/or subarachnoid spaces, which are dilated [1,2].

In children, hydrocephalus is almost always associated with increased intracranial pressure (ICP). In most cases, this is caused by excess CSF accumulating in the cerebral ventricles due to disturbances of CSF circulation (known as obstructive or non-communicating hydrocephalus). Less often, the CSF accumulates because of impaired absorption (known as communicating hydrocephalus). These types of hydrocephalus will be the focus of this topic review.

By contrast, in normal pressure hydrocephalus, the cerebral ventricles are pathologically enlarged, but the ICP is within the normal range. This condition is usually caused by impaired CSF absorption. This type of hydrocephalus is more often seen in adults and is discussed separately. (See "Normal pressure hydrocephalus".)

These forms of hydrocephalus are distinct from two radiographic findings that include the same word. The term "hydrocephalus ex-vacuo" refers to dilatation of the ventricles secondary to brain atrophy or loss of brain tissue secondary to an insult; hydrocephalus ex-vacuo is not accompanied by increased ICP. The term "external hydrocephalus" or "benign enlargement of the extra-axial spaces" refers to excessive fluid, usually CSF, in the subarachnoid spaces and is associated with familial macrocephaly [3,4].

EPIDEMIOLOGY

The prevalence of congenital and infantile hydrocephalus in the United States and Europe has been estimated as 0.5 to 0.8 per 1000 live and still births [5-7]. Approximately 15 to 25 percent of these cases are associated with myelomeningocele (spina bifida) [6,8].

                                           

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Literature review current through: Nov 2016. | This topic last updated: Mon May 11 00:00:00 GMT+00:00 2015.
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