Hydrocephalus

Hydrocephalus is enlargement of head because of increase in cerebrospinal fluid in the brain. There is increased intra cerebral pressure because of enlarged ventricular system. The child presented with enlarged head circumference, vomitings and eye abnormality (Sunset sign). The hydrocephalus may be congenital i.e. from birth because of the obstruction in the CSF pathway (Congenital aqueductal stenosis) or it may be acquired because of bacterial or tuberculous meningitis. The CAT scan of the brain shows enlarged ventricles. Anterior cerebral artery index (Resistive index) shows there is increased pressure inside the brain. Brain cortex gets compressed. The eye examination reveals papilloedema suggestive of increased intra cranial tension. The treatment is ventriculo-peritoneal shunt (VP shunt), in which the CSF is diverted from brain to the peritoneal cavity with a shunt tube. Shunt tube is placed in the subcutaneous space over the anterior chest wall. In obstructive hydrocephalus, third ventriculoscopy & removal of aqueductal diaphragm by fogarthy catheter is curative treatment.