Congenital Hydrocephalus

Introduction to Hydrocephalus

Hydrocephalus is a condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within the ventricles or subarachnoid space of the brain. This accumulation leads to increased intracranial pressure, which can result in a variety of neurological symptoms and, if left untreated, can cause brain damage.

The condition can occur at any age but is most common in infants and older adults. It can be congenital (present at birth) or acquired later in life. Hydrocephalus is not a single disease but a pathophysiological condition with multiple causes, presenting challenges in diagnosis and management.



Congenital Hydrocephalus
  1. Question: What is the primary characteristic of congenital hydrocephalus? Answer: Abnormal accumulation of cerebrospinal fluid (CSF) in the brain's ventricles present at birth
  2. Question: Which imaging modality is considered the gold standard for diagnosing congenital hydrocephalus prenatally? Answer: Fetal magnetic resonance imaging (MRI)
  3. Question: What is the most common cause of congenital hydrocephalus? Answer: Aqueductal stenosis
  4. Question: Which chromosomal abnormality is associated with a high risk of congenital hydrocephalus? Answer: Trisomy 18
  5. Question: What is the name of the genetic condition characterized by congenital hydrocephalus, intellectual disability, and adducted thumbs? Answer: L1 syndrome (also known as X-linked hydrocephalus)
  6. Question: Which congenital brain malformation is frequently associated with hydrocephalus? Answer: Chiari II malformation
  7. Question: What is the primary goal of treating congenital hydrocephalus? Answer: To reduce intracranial pressure and prevent further brain damage
  8. Question: Which surgical procedure is most commonly used to treat congenital hydrocephalus? Answer: Ventriculoperitoneal (VP) shunt placement
  9. Question: What is the alternative surgical approach to shunt placement for treating some cases of congenital hydrocephalus? Answer: Endoscopic third ventriculostomy (ETV)
  10. Question: Which clinical sign is often observed in infants with untreated congenital hydrocephalus? Answer: Rapid head circumference growth crossing percentile lines
  11. Question: What is the "sunset eye" sign in infants with hydrocephalus? Answer: Downward deviation of the eyes with visible white sclera above the iris
  12. Question: Which cranial suture typically bulges in infants with increased intracranial pressure due to hydrocephalus? Answer: The anterior fontanelle
  13. Question: What is the name of the condition where CSF accumulates in the subarachnoid space rather than the ventricles? Answer: Communicating hydrocephalus
  14. Question: Which neurodevelopmental outcome is of particular concern in children with treated congenital hydrocephalus? Answer: Cognitive impairment
  15. Question: What is the most common complication of ventriculoperitoneal shunts in the treatment of congenital hydrocephalus? Answer: Shunt infection
  16. Question: Which pathogen is most frequently associated with shunt infections in hydrocephalus treatment? Answer: Staphylococcus epidermidis
  17. Question: What is the term for the gradual enlargement of the skull without increased intracranial pressure in some hydrocephalus cases? Answer: Compensated hydrocephalus
  18. Question: Which imaging finding is characteristic of aqueductal stenosis in congenital hydrocephalus? Answer: Triventricular hydrocephalus with a normal fourth ventricle
  19. Question: What is the name of the rare genetic disorder characterized by hydrocephalus, polyhydramnios, and absent corpus callosum? Answer: Vici syndrome
  20. Question: Which prenatal infection is associated with an increased risk of congenital hydrocephalus? Answer: Congenital cytomegalovirus (CMV) infection
  21. Question: What is the term for the regression of previously acquired skills in children with shunted hydrocephalus? Answer: Shunt failure
  22. Question: Which neurological sign may be present in older children with chronic untreated hydrocephalus? Answer: Parinaud's syndrome (vertical gaze palsy)
  23. Question: What is the name of the surgical technique used to create a new pathway for CSF flow in some cases of congenital hydrocephalus? Answer: Endoscopic third ventriculostomy (ETV)
  24. Question: Which type of congenital hydrocephalus is associated with myelomeningocele? Answer: Chiari II malformation-associated hydrocephalus
  25. Question: What is the term for the condition where the cerebral aqueduct is blocked by a membrane or web? Answer: Membranous aqueductal stenosis
  26. Question: Which imaging modality is preferred for long-term follow-up of children with treated hydrocephalus? Answer: Magnetic resonance imaging (MRI)
  27. Question: What is the name of the rare congenital condition characterized by hydrocephalus, macrocephaly, and port-wine stains? Answer: Sturge-Weber syndrome
  28. Question: Which type of congenital hydrocephalus is associated with excessive CSF production? Answer: Choroid plexus papilloma or carcinoma
  29. Question: What is the term for the enlargement of cerebral ventricles without increased intracranial pressure or progressive ventricular dilatation? Answer: Arrested hydrocephalus
  30. Question: Which neurosurgical procedure may be considered for infants with post-hemorrhagic hydrocephalus before permanent shunt placement? Answer: Temporary ventricular reservoir placement (Ommaya reservoir)


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