Fetopathology and developmental pathology of the embryo and fetus: Hydrocephalus

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+ Atlas of fetal pathology

+ Congenital malformations of individual organ systems

Hydrocephalus

Clinical signs

hydrocephalus can occur during the fetal period
refers to an increase volume of cerebrospinal fluid within the cranium
manifestation:
- head enlargement with wide fontanels and sutures in neonate and child, fetus up to 24 – 30 weeks rarely presents with increased head circumference
- the ventricular system is widely dilated
- brain tissue atrophies, first the white matter, than the cortex
- irreversible damage can be prevented by shunting

Classification

There are 2 types of hydrocephalus:

obstructive hydrocephalusis a result of a space occupying lesion which impedes free passage of the cerebrospinal fluid, this occurs mostly in the aqueduct
communicating (hyporesorptive) hydrocephalusis caused by failure of resorption of cerebrospinal fluid and has no obstruction. Hydrocephalus due to excess of cerebrospinal fluid secretion is very rarely seen in papillomas of choroid plexus.
congenital hydrocephalusis obstructive in majority of cases. The main causes are aqueductal stenosis or atresia, Arnold Chiari malformation, Dandy Walker malformation, corpus callosum agenesis.
ultrasound measurement of ventricular width is easily done prenatally

mild ventriculomegaly (ventricular width 10 – 15 mm)is associated with abnormal karyotype. Otherwise the prognosis of isolated mild ventriculomegaly and normal karyotype is favourable, intelligence normal
severe ventriculomegaly or hydrocephalus (ventricular width more than 15 mm)

aquired hydrocephalushemorrhage, inflammation and tumours are the most common causes

Hydrocefalus, mozek (73984)

Pictures

Hydrocephalus, fetus: Hydrocephalus, fetus, Macro, autopsy (73309)

Hydrocephalus, fetus 28-week: Congenital hydrocephalus, Macro, autopsy (73983) Congenital hydrocephalus, Macro, autopsy (73984) Congenital hydrocephalus, Macro, autopsy (73985) Congenital hydrocephalus, Macro, autopsy (73986)

Hydrocefalus, fetus 23-week: Hydrocephalus, Macro, autopsy (74394) Hydrocephalus, Macro, autopsy (74395)

Hydrocephalus, fetus, ultrasound video: Hydrocephalus, fetus, Ultrasound, video (74010)

Stenosis of the aqueduct: Stenosis of the aqueduct, Macro, autopsy (72086) Stenosis of the aqueduct, Macro, autopsy (72087) Stenosis of the aqueduct, Macro, autopsy (72088) Stenosis of the aqueduct, Macro, autopsy (72089)

Hydrocephalus, child, a large decubitus on the calva: Hydrocephalus, child, Macro, autopsy (72060)

The same case, after letting out a lot of cerebrospinal fluid, the hemispheres collapsed; the actual brain tissue was only a thin layer around the ventricles: Hydrocephalus, child, Macro, autopsy (72061)