Hydrocephalus, caused

Baldauf J, Oertel J, Gaab MR, Schroeder HW. Endoscopic third ventriculostomy for occlusive hydrocephalus caused hy cerehellar infarction. Neurosurgery 2006 59(3) 539-544. Schwab S, Aschoff A, Spranger M, Albert F, Hacke W. The value of intracranial pressure monitoring in acute hemispheric stroke. Neurology 1996 47(2) 393-398. 

Women with a history of six or more deliveries and anomalies of the fetus (for example hydrocephalus causing cephalopelvic disproportion) must also be excluded. 

However, uneventful vaginal deliveries have been reported in patients with two previous cesarean sections in whom labor was induced with vaginal PGE2 (121). Women with a history of six or more deliveries and anomalies of the fetus (for example hydrocephalus causing cephalopelvic disproportion) must also be excluded. 

Fluid transfer implants are required for cases such as hydrocephalus, urinary incontinence, glaucoma-related elevated intraocular pressure, and chronic ear infection. Hydrocephalus, caused by abnormally high pressure of the cerebrospinal fluid in the brain, can be treated by draining the fluid (essentially an ultrafiltrate of blood) through a cannula. Earlier shunts had two one-way valves at either end. However, the more recent Ames shunt has simple slits at the discharging end, which opens when enough fluid... 

An alternative method of managing patients with cerebellar infarction causing obstructive hydrocephalus is endoscopic third ventriculostomy. Baldauf et al. ° reviewed 10 cases managed by the use of endoscopic third ventriculostomy, 8 of whom had clinical improvement (measured as an improvement in the level of consciousness). This therapy is still experimental, and improvement in outcome has not been demonstrated. 

Other disorders that may kill cholinergic and other neurons, thus leading to memory loss. Vascular dementia, formerly multi-infarct dementia, is characterized by dementia that classically has a more stepwise downhill course as compared with Alzheimer s disease, which has a more smoothly progressive downhill course. Multi-infact dementia is caused by multiple strokes, which damage the brain sufficiently to cause dementia and often cause focal neurological signs and symptoms as well. Normal pressure hydrocephalus can cause dementia from dilated cerebral ventricles. Creutzfeldt-... 

With involvement of the cerebellar hemisphere supplied by the PICA, subsequent edema may cause obstruction of the 4th ventricle, hydrocephalus or compression of the medulla oblongata. Clinically, involvement of the entire cerebellar hemisphere can not be distinguished from partial cerebellar infarction (Amarenco and Hauw 1990). Therefore patients with neurological symptoms suggesting infarction within the PICA territory require neuroimaging studies and close clinical monitoring. 

The hematoma continues to expand after stroke onset, frequently causing further deterioration (Brott et al. 1997 Leira et al. 2004). Some brainstem hemorrhages evolve subacutely, particularly those caused by a vascular malformation (O Laoire et al. 1982 Howard 1986). Any large hematoma may cause brain shift, transtentorial herniation, brainstem compression and raised intracranial pressure. Hematomas in the posterior fossa are particularly likely to cause obstructive hydrocephalus. Rupture into the ventricles or on to the surface of the brain is common, causing blood to appear in the subarachnoid space. 

Thrombosis in the dural sinuses or cerebral veins is much less common than cerebral arterial thromboembolism. It causes a variety of clinical syndromes, which often do not resemble stroke (Bousser and Ross Russell 1997). While ischemic arterial stroke and cerebral venous thrombosis share some causes (Southwick et al. 1986), others are specific to cerebral venous thrombosis (Table 29.1). A particularly high index of suspicion is required in women on the oral contraceptive pill (Saadatnia and Tajmirriahi 2007) and in the puerperium. In the past, cerebral venous thrombosis was strongly associated with otitis media and mastoiditis, lateral sinus thrombosis or otitic hydrocephalus, but the most common causes are now pregnancy and the puerperium, which cause 5-20% of the cerebral venous thrombosis in the developed world, the oral contraceptive pill, malignancy, dehydration, inflammatory disorders and hereditary coagulation disorders. No cause is found in around 20% of cases. 

Fig. 7 (a) Diffusion-weighted MRI of a patient with laige middle cerebral artery stroke. There is involvement of the entire vessel territory with possibly some hemorrhage in the basal ganglia. The image was made within hours of the infarct and there is minimal compression of the ventricles, (b) CT days after the infarct shows the massive shift of the midUne structures away from the evolving mass lesion. Compression of the CSF outflow tracts causes the hydrocephalus with interstitial edema in the white matter adjacent to the ventricles... 

In addition, other possible causes of dementia also need to be excluded, especially the treatable forms of cognitive impairment, such as that due to depression, chronic drug intoxication, chronic central nervous system infection, thyroid disease, vitamin deficiencies (i.e.. Bn and thiamine), central nervous system angitis, and normal-pressure hydrocephalus (Bird, 2008). Individuals who do not meet these criteria but have short-term memory loss and have only minimal impairment in other cognitive abilities and are not functionally impaired at work or at home are considered to have mild cognitive impairment (Petersen et al., 2001). 

Gottrand F, Leclerc F, Chenaud M, VaUee L, Gaudier B. Une cause rare d hydrocephalie du nourrisson I intoxica-tion chronique par la vitamine A. [A rare cause of hydrocephalus in an infant chronic vitamin A poisoning.] Arch Fr Pediatr 1986 43(7) 501-2. 

Primary peritonitis in adults occurs most commonly in association with alcoholic cirrhosis, especially in its end stage, or with ascites caused by postnecrotic cirrhosis, chronic active hepatitis, acute viral hepatitis, congestive heart failure, malignancy, systemic lupus erythematosus, or nephritic syndrome. It also may result from the use of a peritoneal catheter for dialysis or central nervous system ventriculoperitoneal shunting for hydrocephalus. Rarely, primary peritonitis occurs without apparent underlying disease. 

Infection with T. gondii is an important cause of diseases of the central nervous system and the eye in immunocompromised as well as immunocompetent individuals. When first acquired by the mother, this infection can be transmitted to the fetus. Infants with the most severe clinical signs in the brain and eye are those infected early in pregnancy when fetal immunity is low (Jamieson et ah, 2009). At birth, infants infected in utero may have intracranial calcification, hydrocephalus, convulsions, and ocular diseases such as retinochoroiditis or inflammation of the retina and choroid, with associated vitritis. The severity of disease is influenced by the trimester in which the infection is acquired by the mother (Dunn et al, 1999 Remington et ah, 2006). A positive correlation exists between the rate of transmission and infection during the second or third trimesters of pregnancy (Desmonts and Couvreur, 1984 Dunn et ah, 1999). 

Albendazole also is the preferred treatment of neurocysticercosis caused by larval forms of T. solium. The recommended dose is 400 mg given twice a day for adults for 8-30 days, depending on the number, type, and location of the cysts. For children, the dose is 15 mg/kg/day (maximum 800 mg) in two doses for 8-30 days. The course can be repeated as necessary, as long as liver and bone marrow toxicides are monitored. To reduce inflammatory side effects, glucocorticoids are usually given for several days before initiating albendazole therapy. Such pretreatment also increases plasma levels of albendazole sulfoxide. Therapy with either albendazole or praziquantel should include consideration of anticonvulsant therapy, the possible development of complications of arachnoiditis, vasculitis, or cerebral edema, and the need for surgical intervention should obstructive hydrocephalus occur. Albendazole, 400 mg/day, also has shown efficacy for therapy of microsporidial intestinal infections in patients with AIDS. 

Many other possible causes of dialysis dementia have been proposed. These inclnde other trace element contaminants, normal pressure hydrocephalus, slow virus infection of the central nervous system, and regional alterations in cerebral blood flow (Arieff, 1990). Slow virus infection of the nervous system is a possible etiology for dialysis dementia. The clinical manifestations resemble those of other slow virus infections, such as Kuru or Creutzfeldt-Jakob disease (Selkoe, 1978 4714 Gajdusek, 1985 1662). 

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