How is normal cranial pressure hydrocephalus to return a responsibility?

summary

Normal intracranial pressure hydrocephalus refers to normal intraventricular pressure with ventricular enlargement. The main clinical manifestations were gait instability, slow response and urinary incontinence. After shunt treatment, gait instability and mental retardation were improved to some extent. Let's share my experience with you.

How is normal cranial pressure hydrocephalus to return a responsibility?

The etiology can be divided into two categories, one is a clear cause, such as subarachnoid hemorrhage and meningitis. The other is sporadic without obvious etiology. The main pathological changes of the disease are enlargement of ventricular system, adhesion and occlusion of subarachnoid space on the convex or bottom of brain. The most common cause is subarachnoid hemorrhage, followed by intracranial tumors, and familial normal intracranial pressure hydrocephalus.

The disease sometimes results in extensive subarachnoid obstruction at the base of the brain. Meningeal infection, such as tuberculous meningitis, is easy to produce arachnoid adhesion in the later stage of the disease; Traumatic subarachnoid hemorrhage and intracranial surgical bleeding into the subarachnoid space can produce hydrocephalus. Recently, it has been suggested that mesencephalic aqueduct stenosis is also a common cause.

Normal intracranial pressure hydrocephalus is mainly differentiated from cerebral atrophy. The former may have a history of spontaneous subarachnoid hemorrhage (such as sudden severe headache, nausea, vomiting, neck stiffness), head injury, meningitis and brain tumor after operation.

matters needing attention

Generally speaking, for patients with definite etiology, such as subarachnoid hemorrhage, meningitis, trauma, brain surgery, the operation effect is better than that of patients without definite etiology; The short course (less than half a year) is better than the long course; The operation effect of young patients is better than that of old patients. The shunt effect was evaluated by lumbar puncture or intracranial pressure monitoring to determine whether the intracranial pressure decreased. If the symptoms are not improved and the ventricles are still enlarged, the lower pressure shunt should be replaced.