​Pathology - Hydrocephalus

​Pathology - Hydrocephalus
Hydrocephalus is caused by the buildup of excess cerebrospinal fluid in the skull, which can be due to blockages in CSF flow caused by tumors or inflammation, or by the excessive production of CSF by tumors in the choroid plexus.

Pathology: Ventricular dilation observed on gross examination.
There are four types of hydrocephalus: (1) Internal hydrocephalus: excess cerebrospinal fluid (CSF) is found exclusively in the ventricular system; (2) External hydrocephalus: excess CSF is found only in the subarachnoid space; (3) Communicating hydrocephalus: CSF flows freely between the ventricles and subarachnoid space; (4) Noncommunicating hydrocephalus: there is an obstruction in the flow of CSF between the ventricles and subarachnoid space.

Clinical Symptoms  and Signs 
May manifest as skull enlargement in adults, seizures, headaches, vision problems, nausea, vomiting, and other symptoms of elevated intracranial pressure.

Therapy 
Placement of ventriculoperitoneal shunt; extraction of blockage or choroid plexus tumor.
Hydrocephalus ex vacuo is the enlargement of the brain's ventricles due to a higher volume of cerebrospinal fluid caused by a reduction in brain tissue, typically due to conditions like infarction or Alzheimer's disease.

Normal-pressure hydrocephalus is a clinical condition identified by the presence of magnetic gait, urine incontinence, and dementia. Brain imaging shows ventricular enlargement. A lumbar puncture shows a normal opening pressure and offers both diagnostic and therapeutic advantages, as symptoms improve when cerebrospinal fluid is removed during the procedure. The definitive treatment involves the insertion of a ventriculoperitoneal shunt.