VENTRICLES AND BRAIN DISORDERS

VENTRICLES AND BRAIN DISORDERS

Hydrocephalus Enlarged ventricles
By: Arnold Chiari

Syringomyelia/syringobulbia
Hydrocephalus
Communicative hydrocephalus:
Obstructive hydrocephalus:
Hydrocephalus
Traumatic brain injury:
Hydrocephalus in Children
Aqueductal stenosis/compression
Arnold Chiari
Communicative hydrocephalus: increased production or impaired absorption
Postmeningitis or posthemorrhagic – decreased absorption
Signs and Tests
Signs:
Tapping the skull: abnormal sound indicates thinning
Enlarged head
Eyes have sunken in look, setting sun appearance
Abnormal reflexes

Tests:
Head CT scan
Angiogram
Ultrasound
Treatment:
VP (ventriculo-peritoneal) shunt: brain to abdomen
Ventriculostomy: 3rd ventricle to subarachnoid space
Remove the blockage
Arnold Chiari Malformation
Blockage of CSF and formation of syringomyelia
Types of Arnold Chiari
* Type I: may not be symptomatic
* Type II: usually accompanied by myelomeningocele
* Type III: most serious form with severe neurological defects
* Hydrodynamic: hydrocephalus applies pressure to brain
* Traction: tethered cord pulls the brain downward
* Small posterior fossa: Normal brain size pushed brain downward

Theories on etiology
Surgical Treatment of Arnold Chiari Malformation

* Suboccipital decompression
* Cerebellar tonsils are shrunk
* Cranial nerves are decompressed
* Dural patch is applied
Neural elements monitored during surgery
Somatosensory evoked potentials
Motor evoked potentials
Cranial nerves 10, 11, and 12

Syringomyelia
CSF filled cavity in the spinal cord (syrinx)
Arnold Chiari
Spinal cord injury
Tumors
Treatment
Remove the cause
Shunt
Laminectomy
Open dura
Midline myelotomy
Insert tube into syrinx
Midline myelotomy
Baseline
Closing
Shunt placement
Right Tibial N. SEP
Right Abd. Halluc. MEP
Enlarged Ventricles
Parkinson’s Disease

VENTRICLES AND BRAIN DISORDERS.ppt