Posttraumatic hydrocephalus top neuro docs neuro physiotherapy exercises

PTH may result from 1 or a combination of pathophysiologic neuro physiotherapy exercises factors. It can be caused by the overproduction of cerebrospinal fluid neuro physiotherapy exercises (CSF), the blockage of normal CSF flow, or insufficient absorption that results in excessive accumulation of CSF neuro physiotherapy exercises around the brain. Ultimately, PTH is caused by an imbalance that occurs between CSF neuro physiotherapy exercises production and absorption.

PTH may present as normal pressure hydrocephalus (NPH) or as a syndrome of increased intracranial pressure. Because of differences in prognosis and treatment, PTH needs to be distinguished from cerebral atrophy (i.E., hydrocephalus ex vacuo) and ventricular enlargement caused by a failure of brain development. If PTH goes unrecognized or untreated, increased morbidity or mortality following a TBI is more likely. Classification

Conversely, in communicating hydrocephalus (also referred to as nonobstructive hydrocephalus), full communication between the ventricles and the subarachnoid space exists. Impaired CSF absorption may cause communicating hydrocephalus. The apparent mechanism is partial occlusion of the arachnoid villi, perhaps by blood and inflammatory mediators. Severe skull fractures, hemorrhage, and meningitis may predispose patients to this variant of PTH. Another possible mechanism is increased duralsinus pressure, causing decreased CSF outflow.

NPH, a form of communicating hydrocephalus, may result from subarachnoid hemorrhage caused by an aneurysm rupture neuro physiotherapy exercises or a TBI, encephalopathy, or alzheimer disease. NPH often presents as the classic triad of a progressive neuro physiotherapy exercises gait disorder, impairment of mental function, and urinary incontinence. In NPH, ventricles enlarge despite normal or even slightly reduced intracranial pressure, and they continue to press against brain parenchyma. Causes

CSF is primarily produced in the lateral ventricles by the neuro physiotherapy exercises choroids plexus at a rate of 500 ml/d. The CSF flows down toward the third ventricle through the neuro physiotherapy exercises foramen of monro and into the fourth ventricle through the neuro physiotherapy exercises cerebral aqueducts. The CSF then exits the ventricular system through the foramen neuro physiotherapy exercises of magendie (medially) and the foramen of luschka (literally) and flows into the perimedullary and perispinal subarachnoid spaces. The CSF continues around the brainstem to the basal and neuro physiotherapy exercises ambient cisterns. It then flows to the lateral and superior surfaces of neuro physiotherapy exercises the cerebral hemispheres, where it is largely absorbed through the arachnoid villi. The total volume of CSF is replaced several times daily. Frequency

• radioiodinated serum albumin (RISA) injected into the subarachnoid space by way of lumbar puncture neuro physiotherapy exercises (LP) can normally be detected in the cisterna magna, basal cisterns, and subtentorial subarachnoid space within 6 hours, with little accumulation in the ventricular system. In NPH, RISA accumulates in the ventricular system with delayed pericerebral diffusion.

Shunting is the most common treatment for hydrocephalus. The outcome is typically favorable. A shunt is usually placed from the right ventricle to neuro physiotherapy exercises the peritoneal space. The right side is normally used to avoid injury to neuro physiotherapy exercises the language centers on the left side of the brain. Shunts are most often equipped with reservoirs that are used neuro physiotherapy exercises for transiently increasing output and for testing the patency of neuro physiotherapy exercises flow.

The resumption of rehabilitation is usually prompt after the placement neuro physiotherapy exercises of a ventriculoperitoneal (VP) shunt. Patients are typically observed for 2-3 days postoperatively. They then return to rehabilitation services to complete their brain-injury rehabilitation program. Successful shunting is usually related to more obvious and rapid neuro physiotherapy exercises improvements during rehabilitation efforts. Rehabilitation program

The resumption of rehabilitation is usually prompt after the placement neuro physiotherapy exercises of a ventriculoperitoneal (VP) shunt. Patients are typically observed for 2-3 days postoperatively. They then return to rehabilitation services to complete their brain-injury rehabilitation program. Successful shunting is usually related to more obvious and rapid neuro physiotherapy exercises improvements during rehabilitation efforts.

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