Hydrocefalie

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Hydrocefalie is een pathologische aandoening met een toename van de hoeveelheid cerebrospinaal vocht in een groter wordend ventrikelsysteem (vochtkamers in de hersenen). Dit veroorzaakt een verhoogde intracraniale druk. Dit kan zich langzaam of snel te ontwikkelen.

Zuigelingen presenteren zich met een abnormaal vergrote schedelomtrek (op te volgend op de groeicurve), een gespannen en gebombeerde fontanel, een opvallende stand van de ogen (het zogenoemde zonsondergang-fenomeen), prikkelbaarheid en moeilijkheden bij het drinken. Bij oudere kinderen, wanneer de schedelnaden gesloten zijn, treden symptomen van verhoogde intracraniële druk op: hoofdpijn, braken, verminderd bewustzijn, verminderd gezichtsvermogen, epileptische aanvallen. Indien een verhoogde intracraniele druk lange tijd aanwezig is, zullen de hersenen en de optische zenuwen schade oplopen, wat uiteindelijk leidt tot blindheid of zelfs de dood.

We onderscheiden twee vormen:

Obstructieve hydrocefalie, waarbij het cerebrospinale vocht zijn afvoerweg niet kan volgen, door aanwezigheid van een tumor, cyste of misvorming. Een veel voorkomende oorzaak is echter stenose van de aquaduct (het kanaal dat het derde en vierde ventrikel verbindt).

De behandeling bestaat, waar mogelijk, uit het verwijderen van de obstructie (verwijderen van een tumor bijvoorbeeld). Een alternatieve behandeling kan zijn het vocht via een andere route af te leiden bijvoorbeeld door middel van een endoscopische ventriculostomie of shunt.

Niet-obstructieve hydrocefalie wordt veroorzaakt door aantasting van de natuurlijke gebieden waar het cerebrospinale vocht wordt gereabsorbeerd, meestal door een bloeding of infectie.Bij prematuren bestaat een verhoogd risico op intracraniele bloedingen. Hier is een behandeling met een shunt aangewezen. De shunt is een siliconen katheter die de cerebrospinale vloeistof van de ventrikels naar meestal de buik (peritoneale holte) afleidt, geregeld door een klep.

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The hydrocephalus represents a pathological medical condition with increase of cerebrospinal fluid in an expanding ventricle system (brain cavities). This causes an increased pressure inside the skull, also known as increased intracranial pressure. This may develop slowly or quickly.

Infants present an abnormally enlarged head circumference (demonstrated on the head circumference evolution curve), a tense and bulged fontanelle, a conspicuous eye position (the so-called sundown phenomenon), as well as irritability and difficulties in drinking.

In older children, when the cranial sutures are closed, symptoms of increased intracranial pressure occur (headache, vomiting, impaired consciousness, impaired vision, epileptic seizures). Longer condition of increased pressure will damage the brain and optic nerves, finally leading to blindness or even death.

We distinguish two forms:

Obstructive hydrocephalus, where the cerebrospinal fluid cannot flow its normal path, due to some kind of blockade which can be a mass lesion such as a tumor, cyst, or malformation. A common cause however is stenosis of the aqueduct (the duct connecting the upper and lower brain cavities).

The treatment of the obstructive hydrocephalus aims, whenever possible, at removing the obstruction (remove tumor for example). An alternative treatment may be to create another pathway for the flow of cerebrospinal fluid by endoscopic ventriculostomy or shuntplacement.

Non-obstructive hydrocephalus (hydrocephalus malresorptivus)  is caused by impairment of the natural cerebrospinal fluid resorption areas, mostly caused by hemorrhage or infection. In particular, the still immature brain of premature infants is endangered by intracranial hemorrhages. Here treatment with a shunt is indicated. The shunt is a silicon catheter which drains the cerebrospinal fluid from the ventricles into the abdomen (peritoneal cavity) regulated by a valve.

[:fr]

The hydrocephalus represents a pathological medical condition with increase of cerebrospinal fluid in an expanding ventricle system (brain cavities). This causes an increased pressure inside the skull, also known as increased intracranial pressure. This may develop slowly or quickly.

Infants present an abnormally enlarged head circumference (demonstrated on the head circumference evolution curve), a tense and bulged fontanelle, a conspicuous eye position (the so-called sundown phenomenon), as well as irritability and difficulties in drinking.

In older children, when the cranial sutures are closed, symptoms of increased intracranial pressure occur (headache, vomiting, impaired consciousness, impaired vision, epileptic seizures). Longer condition of increased pressure will damage the brain and optic nerves, finally leading to blindness or even death.

We distinguish two forms:

Obstructive hydrocephalus, where the cerebrospinal fluid cannot flow its normal path, due to some kind of blockade which can be a mass lesion such as a tumor, cyst, or malformation. A common cause however is stenosis of the aqueduct (the duct connecting the upper and lower brain cavities).

The treatment of the obstructive hydrocephalus aims, whenever possible, at removing the obstruction (remove tumor for example). An alternative treatment may be to create another pathway for the flow of cerebrospinal fluid by endoscopic ventriculostomy or shuntplacement.

Non-obstructive hydrocephalus (hydrocephalus malresorptivus)  is caused by impairment of the natural cerebrospinal fluid resorption areas, mostly caused by hemorrhage or infection. In particular, the still immature brain of premature infants is endangered by intracranial hemorrhages. Here treatment with a shunt is indicated. The shunt is a silicon catheter which drains the cerebrospinal fluid from the ventricles into the abdomen (peritoneal cavity) regulated by a valve.

[:de]

The hydrocephalus represents a pathological medical condition with increase of cerebrospinal fluid in an expanding ventricle system (brain cavities). This causes an increased pressure inside the skull, also known as increased intracranial pressure. This may develop slowly or quickly.

Infants present an abnormally enlarged head circumference (demonstrated on the head circumference evolution curve), a tense and bulged fontanelle, a conspicuous eye position (the so-called sundown phenomenon), as well as irritability and difficulties in drinking.

In older children, when the cranial sutures are closed, symptoms of increased intracranial pressure occur (headache, vomiting, impaired consciousness, impaired vision, epileptic seizures). Longer condition of increased pressure will damage the brain and optic nerves, finally leading to blindness or even death.

We distinguish two forms:

Obstructive hydrocephalus, where the cerebrospinal fluid cannot flow its normal path, due to some kind of blockade which can be a mass lesion such as a tumor, cyst, or malformation. A common cause however is stenosis of the aqueduct (the duct connecting the upper and lower brain cavities).

The treatment of the obstructive hydrocephalus aims, whenever possible, at removing the obstruction (remove tumor for example). An alternative treatment may be to create another pathway for the flow of cerebrospinal fluid by endoscopic ventriculostomy or shuntplacement.

Non-obstructive hydrocephalus (hydrocephalus malresorptivus)  is caused by impairment of the natural cerebrospinal fluid resorption areas, mostly caused by hemorrhage or infection. In particular, the still immature brain of premature infants is endangered by intracranial hemorrhages. Here treatment with a shunt is indicated. The shunt is a silicon catheter which drains the cerebrospinal fluid from the ventricles into the abdomen (peritoneal cavity) regulated by a valve.

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