Non-communicating hydrocephalus

Non-communicating Hydrocephalus

Non-communicating hydrocephalus, also known as obstructive hydrocephalus, is a condition characterized by an accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain due to a blockage in the ventricular system. This blockage prevents the normal flow and absorption of CSF, leading to increased intracranial pressure and potential damage to brain tissues.

Pathophysiology

The ventricular system of the brain consists of interconnected cavities that produce and circulate CSF. In non-communicating hydrocephalus, the obstruction can occur at various points within this system, most commonly at the:

• Foramen of Monro
• Cerebral aqueduct (Aqueduct of Sylvius)
• Fourth ventricle outlets (Foramina of Luschka and Magendie)

The obstruction leads to an accumulation of CSF upstream of the blockage, causing the ventricles to enlarge and exert pressure on surrounding brain tissues.

Causes

Non-communicating hydrocephalus can be caused by congenital or acquired factors, including:

• Congenital malformations such as aqueductal stenosis
• Arnold-Chiari malformation
• Dandy-Walker syndrome
• Brain tumors
• Infections such as meningitis
• Hemorrhage within the brain

Symptoms

The symptoms of non-communicating hydrocephalus vary depending on the age of onset and the rate of CSF accumulation. Common symptoms include:

• Headache
• Nausea and vomiting
• Blurred or double vision
• Balance and coordination problems
• Cognitive difficulties
• In infants, an increase in head size and a bulging fontanelle

Diagnosis

Diagnosis of non-communicating hydrocephalus typically involves imaging studies such as:

• Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan

These imaging techniques help visualize the enlargement of the ventricles and identify the site of obstruction.

Treatment

The primary treatment for non-communicating hydrocephalus is surgical intervention to restore normal CSF flow. Common procedures include:

• Ventriculoperitoneal shunt placement
• Endoscopic third ventriculostomy (ETV)

These procedures aim to divert the flow of CSF or create a new pathway for its circulation.

Prognosis

The prognosis for individuals with non-communicating hydrocephalus depends on the underlying cause, the timeliness of treatment, and the presence of any complications. Early diagnosis and intervention are crucial for preventing long-term neurological damage.

Also see

• Communicating hydrocephalus
• Normal pressure hydrocephalus
• Hydrocephalus
• Cerebrospinal fluid