0 Hydrocephalus

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 Note : The terms communicating and noncommunicating hydrocephalus are used to indicate extraventricular obstructive hydrocephalus and intraventricular obstructive hydrocephalus, respectively.


Normal CSF : 

  • 75 % produced in ventricles (choroid plexus)
  • 25% Extrachoroidally in capillary endothelium

Normal Rate of production : 20ml/hr


Normal Volume : 
  • 50 ml (infants)
  • 150 ml (Adults)

Image courtesy :  DrShiviMudgal. - MedicoNotebook


Non communicating Hydrocephalus = Intraventricular Obstructive.

Causes :
  1. Most common - Aqueductal Stenosis (MCQ)
  2. Aqueductal gliosis
  3. Vein of gallen malformation (Invg: MR-Angio)
  4. Arnold Chiari malformation
  5. Dandy Walker Malformation
Communicating = Extraventricular obstructive.
i.e - obstruction at basal cistern level
- Has large 4th ventricle.

Causes :
  1. TBM - Contrast enhancing Basal exudates on CT
  2. Pneumococcal Meningitis
  3. Leukaemic Infiltrates
  4. Large IVH in preterm





First Sign of increased ICT :
  • In children : Sutural seperation
  • In Adults : Erosion of posterior clenoid process.


Invg of choice for Hydrocephalus : MRI


Treatment :
  • Medical - Furosemide , Acetazolamide
  • Surgery - Ventriculoperitoneal shunt (complication - blockage , infection usually by coag. negative Staph epidermidis)


MedicoNotebook : Founder - DrShiviMudgal , Co-Founder - DrAyushGoel

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