Internal hydrocephalus of the brain in adults
Hydrocephalus (dropsy) refers to the accumulation of fluid in the hollow brain structures, which include internal the ventricles, cisterns of the brain and spinal cord, and subarachnoid space. In hydrocephalus there is a lot of terminological designations, which are sometimes covered in the articles, sometimes not. There is rezorbtivnoe, internal, open, occlusive hydrocephalus and a variety of other diagnoses. We will understand the classification of hydrocephalus in adults.
Hydrocephalus is called excessive amount of cerebrospinal fluid or cerebrospinal cerebrospinal fluid in the hollow brain structures with their compensatory expansion and emergence of the corresponding clinical picture, which is called «syndrome of increased intracranial pressure».
Classification by localization: inner and outer form
First of all, you need to explain what internal hydrocephalus of the brain. The so-called excessive accumulation of cerebrospinal fluid in the lateral ventricles and the third ventricle. In this form the fluid is under excessive pressure in the internal structures and does not get into the subarachnoid space or convex hemispheres.
If the liquid passes freely into the subarachnoid space surrounding the sulcus and gyrus of the cortex, there is an open form of dropsy. This form is called communicating or mixed, hydrocephalus, as obstacles for the flow of cerebrospinal fluid throughout the system (adhesions, tumors) do not exist.
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It used to be that there is the outer form of hydrocephalus where the subarachnoid space is enlarged in the area of pallium – the gray matter of the cerebral hemispheres. But then it turned out that the excessive accumulation of CSF caused not by violation of CSF dynamics, and cortex atrophy with flattening of the furrows and convolutions. Against this background, is a prominent compensatory enlargement of subarachnoid outdoor spaces.
Important to physicians is the conclusion about the uniformity of dropsy. For example, there is an internal hydrocephalus in which the ventricles have completely the same size, despite their increase. It speaks of the uniform character of the dropsy, which is likely to arise out of or in connection with the increase in production of cerebrospinal fluid (hyperproduction) or inadequate suction (arterbury).
If there is a pronounced difference between the size of the ventricles, there is an asymmetric form of hydrocephalus. It often cause is any volume process (tumor, cyst), which squeezes or ventricles, or lichborne the way, preventing the normal passage of cerebrospinal fluid. In this case, it is necessary to consult a neurosurgeon.
Classification according to the severity of
Dropsy of the brain may be minor, moderate or severe. Because in addition to increasing the size of the structures most important factor in nerve damage is the pressure of the CSF, it is usually the degree of intensity coincides with the normotensive or hypertensive forms. Hypertensive hydrocephalus more severe.
Classification by pathogenesis (origin)
There are three varieties of dropsy of the brain.
- When occlusal form is a violation of current litwareproposal ways, so there is a closed and unreported hydrocephalus, which may be asymmetrical. This is the most dangerous disease which is growing very fast cerebral symptoms.
- Rezorbtivnoe, or disrtibution form – there by reducing the absorption of cerebrospinal fluid in painovich granulations of the ventricles and cerebral sinuses. The CSF is produced at normal speed, but slowly absorbed. Can develop after purulent meningitis and injuries.
- Hyperproduction, or gipersecretornye. With this type of hydrocephalus, the rate of absorption of liquid stored, and the secretion is increased, for example, due to injury or development of tumors vascular plexuses that produce cerebrospinal fluid.
Edema can be rapid (acute), chronic, as well as compensated or decompensated. Acute hydrocephalus develops within a few days and manifests bright symptomatology with the risk of developing edema and herniation of brain substance. Offset form represents a normotensive edema of the brain, which may not manifest itself, as the pressure of the CSF is normal. Decompensation occurs at a time when there are episodes of increased intracranial pressure with appropriate clinical picture.
There are also other special classification of hydrocephalus (distal, proximal), but they are of interest to neurosurgeons. The above classification will allow more confident to navigate the patients in the disease pattern and ask questions to the attending physician with knowledge of the matter.
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