Hydrocephalus, from the Greek words _______ (water) and _______ (head), is one of the most common pediatric and infant conditions.
Hydrocephalus, from the Greek words hydro (water) and kefala (head), is one of the most common pediatric and infant conditions.
Annual specialized health expenditures for hydrocephalus cost approximately _______ in the United States and beyond _______ in sub-Saharan Africa.
Annual specialized health expenditures for hydrocephalus cost approximately \(2 billion in the United States and beyond \)1 billion in sub-Saharan Africa.
Hydrocephalus occurs due to an abnormal buildup of _______ in the _______ of the brain.
Hydrocephalus occurs due to an abnormal buildup of cerebrospinal fluid (CSF) in the ventricular spaces of the brain.
The buildup of CSF in hydrocephalus leads to _______, _______, and various _______.
The buildup of CSF in hydrocephalus leads to increased intracranial pressures (ICPs), splaying of cranial suture lines, and various neurologic symptoms and deficits.
The morbidity burden of hydrocephalus can be very high, especially in infants, with possible long-term neurologic sequelae including _______, _______, and _______.
The morbidity burden of hydrocephalus can be very high, especially in infants, with possible long-term neurologic sequelae including cerebral palsy, epilepsy, and cognitive and behavioral delays.
_______ was one of the first to describe accumulation of water in the brain as hydrocephalus in _______.
Hippocrates was one of the first to describe accumulation of water in the brain as hydrocephalus in 400 BC.
By the _______, it was accepted that the 'water' in hydrocephalus was _______, and symptoms resulted from _______.
By the 1800s, it was accepted that the 'water' in hydrocephalus was CSF, and symptoms resulted from increased ICP.
Direct drainage of CSF, either as a _______ from the brain or a _______ from the thecal sac, provided symptom relief for hydrocephalus.
Direct drainage of CSF, either as a ventriculostomy from the brain or a lumbar puncture from the thecal sac, provided symptom relief for hydrocephalus.
By the early _______, surgical treatments for hydrocephalus, such as _______ and _______ to the peritoneum, proved more effective and safe.
By the early 1900s, surgical treatments for hydrocephalus, such as third ventriculostomies and ventricular shunting to the peritoneum, proved more effective and safe.
_______ refers to the clinical manifestations of increased ICPs, including increasing head circumference and irritability in infants.
Hydrocephalus refers to the clinical manifestations of increased ICPs, including increasing head circumference and irritability in infants.
_______ refers to the radiographic increase in ventricle system size.
Ventriculomegaly refers to the radiographic increase in ventricle system size.
_______ refers to a physical head circumference that is above the _______ age-standardized measurement.
Macrocephaly refers to a physical head circumference that is above the 98th percentile age-standardized measurement.
While hydrocephalus can present with _______ and _______, these conditions can also occur due to _______ and are not exclusive to a hydrocephalus diagnosis.
While hydrocephalus can present with ventriculomegaly and macrocephaly, these conditions can also occur due to other causes and are not exclusive to a hydrocephalus diagnosis.
Almost _______ new cases of infant hydrocephalus are diagnosed worldwide each year, approximating a rate of _______ per _______ live births.
Almost 400,000 new cases of infant hydrocephalus are diagnosed worldwide each year, approximating a rate of 20 to 110 per 100,000 live births.
Up to _______ of the global burden of hydrocephalus falls in countries of _______, _______, and _______.
Up to 75% of the global burden of hydrocephalus falls in countries of Africa, Latin America, and Southeast Asia.
The incidence of hydrocephalus is higher in _______ (_______ per 100,000 births) than in _______ (_______ per 100,000 births).
The incidence of hydrocephalus is higher in low- and middle-income countries (123 per 100,000 births) than in high-income countries (79 per 100,000 births).
Disparities in hydrocephalus incidence are driven by quality and access to _______, _______, _______, and _______.
Disparities in hydrocephalus incidence are driven by quality and access to prenatal care and education, endemic infections, poorer diets, and limited access to diagnostic imaging.
In low- and middle-income countries, materials such as _______, _______, and _______ are unavailable, limiting the efficacy of hydrocephalus treatment.
In low- and middle-income countries, materials such as imaging equipment, shunt valves, and endoscopy equipment are unavailable, limiting the efficacy of hydrocephalus treatment.
There are likely many more patients in low- and middle-income countries who do not receive _______ as in high-income countries.
There are likely many more patients in low- and middle-income countries who do not receive timely treatment as in high-income countries.
While in utero, _______ can be detected on surveillance _______.
While in utero, fetal ventriculomegaly can be detected on surveillance ultrasonography.
Fetal ventriculomegaly is defined as a greater-than-normal diameter of the _______, typically greater than _______.
Fetal ventriculomegaly is defined as a greater-than-normal diameter of the lateral ventricle atria, typically greater than 10 mm.
_______ of prenatal imaging is required because ventriculomegaly can also result from _______ and not necessarily reflect hydrocephalus caused by increased ICPs.
Specialist interpretation of prenatal imaging is required because ventriculomegaly can also result from abnormal brain development and not necessarily reflect hydrocephalus caused by increased ICPs.
In infants, signs of hydrocephalus are more _______ than the classic symptoms seen in older children and adults.
In infants, signs of hydrocephalus are more subtle than the classic symptoms seen in older children and adults.
Neonates are born with _______ and _______, which can accommodate increases in _______ more so than a more mature skull.
Neonates are born with open fontanelles and skull sutures, which can accommodate increases in ICP more so than a more mature skull.
Early signs of hydrocephalus in infants are mostly _______ rather than symptomatic.
Early signs of hydrocephalus in infants are mostly physical rather than symptomatic.
Early signs of hydrocephalus in infants include: - _______ - _______ - _______.
Early signs of hydrocephalus in infants include: - growing head circumference crossing multiple percentiles over time - bulging fontanelles - separated (splayed) cranial sutures.
As untreated hydrocephalus progresses, patients may present with: - Initially: _______, _______, _______ - Later: _______, _______, and episodes of _______ and _______.
As untreated hydrocephalus progresses, patients may present with: - Initially: vomiting, irritability, lethargy - Later: seizures, downward deviated gaze, and episodes of apnea and bradycardia.
An infant with evolving hydrocephalus commonly presents with _______ and _______, which can be confused with _______ or _______.
An infant with evolving hydrocephalus commonly presents with irritability and vomiting, which can be confused with infant colic or viral infection.
Parents of an infant with hydrocephalus may note increasing head size and a '_______', which refers to the _______ due to increasing _______.
Parents of an infant with hydrocephalus may note increasing head size and a 'full head', which refers to the fontanelles being pushed outward due to increasing ICPs.
_______ is the most useful procedure to diagnose or rule out hydrocephalus.
Head imaging is the most useful procedure to diagnose or rule out hydrocephalus.
A large head circumference or _______ alone can also arise due to _______ or _______ like _______.
A large head circumference or macrocephaly alone can also arise due to benign anatomic macrocephaly or benign subdural collections like hygromas.
Distinguishing benign macrocephaly from hydrocephalus is important because benign conditions can be misconstrued as _______ in nature.
Distinguishing benign macrocephaly from hydrocephalus is important because benign conditions can be misconstrued as traumatic in nature.
On imaging of hydrocephalus in infants, _______ can often be appreciated.
On imaging of hydrocephalus in infants, enlarged ventricular systems can often be appreciated.
_______ is typically the preferred initial imaging modality for neonates due to _______ and _______.
Head ultrasonography is typically the preferred initial imaging modality for neonates due to lack of radiation exposure and ease at bedside.
_______, particularly using the _______, can identify subtle flow-related abnormalities to diagnose hydrocephalus types.
Magnetic resonance imaging without contrast, particularly using the cine flow sequence, can identify subtle flow-related abnormalities to diagnose hydrocephalus types.
CSF is a _______, _______ derived from _______.
CSF is a clear, acellular liquid derived from plasma.
CSF circulates in the _______ of the _______, covering the _______ and _______.
CSF circulates in the subarachnoid space of the central nervous system, covering the brain and spine.
CSF plays a crucial role in: - _______ - _______ - _______ from the central nervous system - Providing _______.
CSF plays a crucial role in: - protecting - nourishing - removing waste from the central nervous system - Providing mechanical shock absorbance.
Hydrocephalus, from the Greek words hydro (water) and kefala (head), is one of the most common pediatric and infant conditions.
Annual specialized health expenditures for hydrocephalus cost approximately \(2 billion in the United States and beyond \)1 billion in sub-Saharan Africa.
Hydrocephalus occurs due to an abnormal buildup of cerebrospinal fluid (CSF) in the ventricular spaces of the brain.
The buildup of CSF in hydrocephalus leads to increased intracranial pressures (ICPs), splaying of cranial suture lines, and various neurologic symptoms and deficits.
The morbidity burden of hydrocephalus can be very high, especially in infants, with possible long-term neurologic sequelae including cerebral palsy, epilepsy, and cognitive and behavioral delays.
Hippocrates was one of the first to describe accumulation of water in the brain as hydrocephalus in 400 BC.
By the 1800s, it was accepted that the 'water' in hydrocephalus was CSF, and symptoms resulted from increased ICP.
Direct drainage of CSF, either as a ventriculostomy from the brain or a lumbar puncture from the thecal sac, provided symptom relief for hydrocephalus.
By the early 1900s, surgical treatments for hydrocephalus, such as third ventriculostomies and ventricular shunting to the peritoneum, proved more effective and safe.
Hydrocephalus refers to the clinical manifestations of increased ICPs, including increasing head circumference and irritability in infants.
Macrocephaly refers to a physical head circumference that is above the 98th percentile age-standardized measurement.
While hydrocephalus can present with ventriculomegaly and macrocephaly, these conditions can also occur due to other causes and are not exclusive to a hydrocephalus diagnosis.
Almost 400,000 new cases of infant hydrocephalus are diagnosed worldwide each year, approximating a rate of 20 to 110 per 100,000 live births.
Up to 75% of the global burden of hydrocephalus falls in countries of Africa, Latin America, and Southeast Asia.
The incidence of hydrocephalus is higher in low- and middle-income countries (123 per 100,000 births) than in high-income countries (79 per 100,000 births).
Disparities in hydrocephalus incidence are driven by quality and access to prenatal care and education, endemic infections, poorer diets, and limited access to diagnostic imaging.
In low- and middle-income countries, materials such as imaging equipment, shunt valves, and endoscopy equipment are unavailable, limiting the efficacy of hydrocephalus treatment.
There are likely many more patients in low- and middle-income countries who do not receive timely treatment as in high-income countries.
Fetal ventriculomegaly is defined as a greater-than-normal diameter of the lateral ventricle atria, typically greater than 10 mm.
Specialist interpretation of prenatal imaging is required because ventriculomegaly can also result from abnormal brain development and not necessarily reflect hydrocephalus caused by increased ICPs.
In infants, signs of hydrocephalus are more subtle than the classic symptoms seen in older children and adults.
Neonates are born with open fontanelles and skull sutures, which can accommodate increases in ICP more so than a more mature skull.
Early signs of hydrocephalus in infants include: - growing head circumference crossing multiple percentiles over time - bulging fontanelles - separated (splayed) cranial sutures.
As untreated hydrocephalus progresses, patients may present with: - Initially: vomiting, irritability, lethargy - Later: seizures, downward deviated gaze, and episodes of apnea and bradycardia.
An infant with evolving hydrocephalus commonly presents with irritability and vomiting, which can be confused with infant colic or viral infection.
Parents of an infant with hydrocephalus may note increasing head size and a 'full head', which refers to the fontanelles being pushed outward due to increasing ICPs.
A large head circumference or macrocephaly alone can also arise due to benign anatomic macrocephaly or benign subdural collections like hygromas.
Distinguishing benign macrocephaly from hydrocephalus is important because benign conditions can be misconstrued as traumatic in nature.
Head ultrasonography is typically the preferred initial imaging modality for neonates due to lack of radiation exposure and ease at bedside.
Magnetic resonance imaging without contrast, particularly using the cine flow sequence, can identify subtle flow-related abnormalities to diagnose hydrocephalus types.
CSF circulates in the subarachnoid space of the central nervous system, covering the brain and spine.
CSF plays a crucial role in: - protecting - nourishing - removing waste from the central nervous system - Providing mechanical shock absorbance.
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