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If left untreated, symptoms of gait disturbance, cognitive impairment, and urinary incontinence may continue to worsen and ultimately lead to death. Patients with a successful VP shunt can live a typically normal life with no restrictions to activities of daily living. [36]
Hydrocephalus can be classified via mechanism into communicating, noncommunicating, ex vacuo, and normal pressure hydrocephalus. Diagnosis is made by physical examination and medical imaging, such as a CT scan. [1] Hydrocephalus is typically treated through surgery. One option is the placement of a shunt system. [1]
The CSF tap test, sometimes lumbar tap test or Miller Fisher Test, is a medical test that is used to decide whether shunting of cerebrospinal fluid (CSF) would be helpful in a patient with suspected normal pressure hydrocephalus (NPH).
Normal pressure hydrocephalus (NPH) looks at CSF flow values and velocities, which is important for diagnosis because NPH is idiopathic and has varying symptoms amongst patients including urinary incontinence, dementia, and gait disturbances. Increased aqueduct CSF stroke volume and velocity are indicators of NPH. [7]
In the setting of raised pressure (or normal pressure hydrocephalus, where the pressure is normal but there is excessive CSF), lumbar puncture may be therapeutic. [27] Decreased CSF pressure can indicate complete subarachnoid blockage, leakage of spinal fluid, severe dehydration, hyperosmolality, or circulatory collapse. Significant changes in ...
When a patient has communicating hydrocephalus, the lateral ventricles and medial parts of the temporal lobes expand and compress the aqueduct. As a result, the pressure within the fourth ventricle drops and causes the aqueduct to close more tightly. This in effect could make aqueductal stenosis a byproduct of hydrocephalus. [8]
Intracranial pressure (ICP) is the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. ICP is measured in millimeters of mercury and at rest, is normally 7–15 mmHg for a supine adult. This equals to 9–20 cmH 2 O, which is a common scale used in lumbar punctures. [1]
Brain herniation is a potentially deadly side effect of very high pressure within the skull that occurs when a part of the brain is squeezed across structures within the skull. The brain can shift across such structures as the falx cerebri , the tentorium cerebelli , and even through the foramen magnum (the hole in the base of the skull through ...