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The most common cause of congenital hydrocephalus is aqueductal stenosis, which occurs when the narrow passage between the third and fourth ventricles in the brain is blocked or too narrow to allow sufficient cerebral spinal fluid to drain. Fluid accumulates in the upper ventricles, causing hydrocephalus. [16]
An external ventricular drain (EVD), also known as a ventriculostomy or extraventricular drain, is a device used in neurosurgery to treat hydrocephalus and relieve elevated intracranial pressure when the normal flow of cerebrospinal fluid (CSF) inside the brain is obstructed.
Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the brain, and absorbed in the arachnoid granulations .
In cases of aqueductal stenosis caused by tumor compression, a brain tumor in the region of the midbrain forms. More specific anatomically, a tumor forms in the pineal region which is dorsal to the midbrain and is level with the aqueduct of Sylvius. [2] As the tumor grows and expands, it compresses the aqueduct to eventually obstruct it.
This can cause severe brain damage by compressing the brain, and a subdural hematoma may develop. Extra-axial fluid collection can be treated in three different ways depending on the severity of the condition. Usually the shunt will be replaced or reprogrammed to release less CSF, and the fluid that has collected around the brain will be drained.
As a part of the lymphatic system, the meningeal lymphatics are responsible for draining immune cells, small molecules, and excess fluid from the CNS into the deep cervical lymph nodes. [1] [2] Cerebrospinal fluid and interstitial fluid are exchanged, and drained by the meningeal lymphatic vessels. [3]
Cerebrospinal fluid diversion is a procedure that is used to drain fluid from the brain and spinal cord. A shunt is placed in a ventricle of the brain and threaded under the skin to another part of the body, usually the abdomen. It is used to treat hydrocephalus and idiopathic intracranial hypertension.
It is done by surgically penetrating the skull, dura mater, and brain such that the ventricular system ventricle of the brain is accessed. When catheter drainage is temporary, it is commonly referred to as an external ventricular drain (EVD). When catheter drainage is permanent, it is usually referred to as a shunt.