Related Experiment Video
Updated: Jun 12, 2026
04:12
Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats
Published on: March 28, 2025
Huge hydrocephalus: definition, management, and complications
Morteza Faghih Jouibari1, Nazanin Baradaran, Rouzbeh Shams Amiri
1Department of Neurosurgery, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
Summary
Management of huge hydrocephalus (HH) in infants requires careful consideration due to high complication rates. Programmable shunts are recommended to control drainage and mitigate risks like infection and developmental delays.
Area of Science:
- Pediatric Neurosurgery
- Neurology
- Medical Management
Background:
- Huge hydrocephalus (HH) presents unique challenges compared to common hydrocephalus.
- Parental socioeconomic factors and lack of knowledge can lead to delayed treatment, resulting in progressive HH and macrocephaly.
- Effective management strategies are crucial for improving outcomes in infants with HH.
Purpose of the Study:
- To present the clinical experience in managing infants with huge hydrocephalus (HH).
- To analyze the causes, treatment outcomes, and complications associated with HH management.
- To highlight the importance of appropriate shunt technology in HH patients.
Main Methods:
- Definition of HH: head circumference greater than infant's height.
- Surgical intervention involved shunting in nine infants diagnosed with HH.
- Follow-up duration ranged from 0.5 to 7 years post-shunting.
Main Results:
- Aqueductal stenosis was the most frequent cause of HH.
- The average age at shunting was 3 months, with head circumferences averaging 67 cm (range 56-94 cm).
- Five patients had age-appropriate cognitive status, but only one showed normal motor development. Complications included subdural effusion (6), shunt infection (4), and mortality (3) due to infection/sepsis.
Conclusions:
- Patients with HH face significant risks of complications post-shunt surgery, including subdural effusion, ventricular collapse, and shunt infection.
- Mental and motor disabilities are prevalent in infants with HH.
- Programmable shunts are advised to control overdrainage, a potential cause of complications.
Related Concept Videos
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:19Cerebral Edema l: Introduction
Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:21Cytotoxic Edema: Pathophysiology
Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous supply...