Differential Diagnosis of Hydrocephalus脑积水的鉴别诊断.pptVIP

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Differential Diagnosis of Hydrocephalus脑积水的鉴别诊断.ppt

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* * * * * * * * * * * * * * * 4th Ventricle obstruction : Intraventricular Tumour: Ependymoma, metastases Extraventricular Tumours: medulloblastoma, haemangioblastoma, cerebellopontine angle tumours (acoutic neuroma) , meningioma Outflow obstrction: infection (TB), SAH, leptomeningeal malignancy Ependymoma Medulloblastoma : Cerebellar Haemangioblastoma Intraventricular Haemorrhage: Acoustic Neuroma: Communicating Hydrocephalus: There is free flow throughout the ventricular system. Impaired CSF resorption by the arachnoid granulation accounts for majority of cases SAH Infectious meningitis Malignant meningitis Granulomatous mningitis : TB , sarcoidosis Altered venous Dynamics : Vein of Galen malformation, venous obstruction TB Meningitis : Vein of Galen : Vein of Galen Thank you * * * * * * * * * * * * * * * * * * * * * Differential Diagnosis of Hydrocephalus By: Nour-Eldin Mohammed Ref : Radiological Differential Diagnosis : Stephen Chapman,2003 The Normal CSF Flow Hydrocephalus Abnormal dilatation of the cerebral ventricular system Hydrocephalus should be differentiated from disorders producing ventricular enlargement secondary to cerebral atrophy. Classified into : Communicating Hydrocephalus Non communicating Hydrocephalus Characterisics of Hydrocephalus Ventricular enlargement disproportionate to the degree of sulcal widening Enlagement of temporal horne Periventricular fluid 2ry to transependymal CSF permeation Enlarged 3rd ventricle with large suprapineal and chiasmatic receses In children 2 years the head circumference is often the best distinguishing feature between hydrocephalus and atrophy. Normal CT Brain Hydrocephalic Brain Subependymal CSF permeation Non-Communicating Hydrocephalus (Intraventricular obstruction) Ventricular dilatation caused by intraventricular obstruction at or above the the outlet foramina of the 4th ventricle Causes: Lateral ventricle Foramen of Monro 3rd ventricle Aqueduct of sylvius 4th ventricle Lateral Ventriclar causes: