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- Title
Diagnostic Nuances and Surgical Management of Arrested Hydrocephalus.
- Authors
Panigrahi, Manas; Kodali, Sandhya; Chandrsekhar, Y; Vooturi, Sudhindra; Panigrahi, Manas K; Chandrsekhar, Y B V K
- Abstract
Hydrocephalus is characterized by the increased volume of cerebrospinal fluid (CSF) with enlarged cerebral ventricles. In nearly 50% of the patients, if left untreated, the balance between CSF production and absorption is achieved, resulting in arrested hydrocephalus (AH). However, 15% of them who are diagnosed as arrested can progress over a period of time. Importantly, a large fraction of patients with hydrocephalus in India, may not have access to tertiary level care. Therefore, both progressive hydrocephalus and insidious progression of AH with related mortality and morbidity could be higher in India. The pathophysiology behind AH and insidious progression of AH are poorly established. Unfortunately, there are no established clinical or radiological parameters identifying or predicting AH from progressive hydrocephalous. Diagnosis is often based on a combination of neurological, psychometric, and magnetic resonance imaging (MRI) findings. Invasive monitoring of intracranial pressure (ICP) and telemetric ICP measurement is increasingly helping surgeons to detect insidious progressive AH in the early stages. In patients with AH, surgery may not be always necessary and a conservative approach is often adopted. On the contrary, AH that becomes progressive may require intervention. Surgical intervention should not be delayed and endoscopic third ventriculostomy (ETV) is preferable over shunt placement. Importantly, comprehensive counseling and the appropriate selection of patients are pivotal in improving outcomes and reducing complications.
- Subjects
INDIA; HYDROCEPHALUS; CEREBROSPINAL fluid shunts; PATIENT selection; CEREBRAL ventricles; MAGNETIC resonance imaging; INTRACRANIAL pressure
- Publication
Neurology India, 2021, Vol 69, p332
- ISSN
0028-3886
- Publication type
journal article
- DOI
10.4103/0028-3886.332262