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Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Increased Intracranial Pressure l: Introduction01:14

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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...
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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...
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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...
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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...

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Related Experiment Video

Updated: May 12, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Paediatric hydrocephalus.

Kristopher T Kahle1,2,3, Petra M Klinge4, Jenna E Koschnitzky5

  • 1Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. kahle.kristopher@mgh.harvard.edu.

Nature Reviews. Disease Primers
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Hydrocephalus, a cerebrospinal fluid (CSF) imbalance, causes ventricle expansion. Advances in genomics and imaging offer new hope for precise prognostication and non-surgical treatments for this condition.

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Area of Science:

  • Neurology
  • Pediatrics
  • Genetics

Background:

  • Hydrocephalus involves cerebrospinal fluid (CSF) imbalance, leading to cerebral ventricle expansion.
  • It presents as increased head circumference in infants and elevated intracranial pressure in older children.
  • Causes include genetic mutations (congenital) or CNS infection/hemorrhage (acquired).

Purpose of the Study:

  • To provide a comprehensive overview of hydrocephalus, encompassing its pathophysiology, clinical presentation, and current management strategies.
  • To highlight the impact of recent technological advancements on understanding and treating hydrocephalus.
  • To explore the evolving landscape of hydrocephalus research and therapeutic development.

Main Methods:

  • Review of existing literature on hydrocephalus pathophysiology, diagnosis, and treatment.
  • Analysis of clinical presentations in different age groups.
  • Discussion of genetic factors, neuroimaging, and emerging technologies.

Main Results:

  • Hydrocephalus is characterized by disrupted CSF homeostasis and ventricular enlargement.
  • Clinical manifestations vary with age, ranging from increased head circumference to signs of elevated intracranial pressure.
  • Current treatments involve surgical CSF shunting or endoscopic procedures, with in utero options available for fetal cases.

Conclusions:

  • Long-term outcomes are influenced by genetic and environmental factors.
  • Genomics, advanced brain imaging, and other technologies are crucial for refining diagnosis, improving prognostication, and identifying novel non-surgical treatments.
  • Continued research is essential for advancing hydrocephalus care and improving patient outcomes.