Hydrocephalus (from Greek hydro-, meaning "water", and kephalos, meaning "head") is a medical condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF) in the brain. This causes increased intracranial pressure inside the skull and may cause progressive enlargement of the head if it occurs in childhood, potentially causing convulsion, tunnel vision, and mental disability. It was once informally called "Water on the brain."
Hydrocephalus can be caused by congenital or acquired factors. Congenital causes include Spina Bifida, Arnold–Chiari malformation, craniosynostosis, Dandy–Walker syndrome, and Vein of Galen malformations. Acquired causes include hemorrhage, meningitis, head trauma, tumors, and cysts.
Two types of hydrocephalus are commonly described non-communicating hydrocephalus and communicating hydrocephalus, although there is evidence that communicating forms can lead to obstruction of CSF flow in many instances.
In non-communicating hydrocephalus, the CSF in the ventricles can't reach the subarachnoid space. This results from obstruction ofinterventricular foramina, cerebral aqueduct, or the outflow foramina of the fourth ventricle (median and lateral apertures). The most common obstruction is in the cerebral aqueduct. A block at any of these sites leads rapidly to dilatation of one or more ventricles. If the skull is still pliable, as it is in children younger than two years, the head may enlarge.
In communicating hydrocephalus, the obstruction of CSF flow is in the subarachnoid space from prior bleeding or meningitis. This causes thickening of the arachnoid leading to blockage of the return-flow channels. In some patients, the spaces filled by CSF are uniformly enlarged without an increase in intracranial pressure. This special form of communicating hydrocephalus is called normal pressure hydrocephalus (NPH), which results specifically from impaired CSF reabsorption at the arachnoid granulations. NPH's clinical manifestations are gait abnormality, dementia, and involuntary urination. NPH usually occurs in elderly patients.
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http://www.aerzteblatt.de/pdf/di/109/1/m15.pdf the differential diagnosis and treatment of normal-pressure hydrocephalus by michael kiefer, andreas unterberg deutsches ärzteblatt international | dtsch arztebl int 2012; 109(1–2): 15–26