Children with hydrocephalus of inspection and diagnosis Inspection of the suspicious features of the early patients, measuring the size of the skull, including the circumference, diameter and inter-ear diameter. Normal neonatal head circumference 33 ~ 35cm. Before the skull in 9 to 18 months between the closure, after fontanelle closed six weeks after birth, the data for reference. To further confirm the diagnosis, understanding the existence of hydrocephalus, as well as the nature and extent of inspection can be carried out as follows: 1. Skull X-ray; 2. Cranial CT scanning; if necessary, magnetic resonance imaging can be used for the head (MRI). More than 20 years ago, the head ultrasound and angiography ventricle is extremely popular; now been replaced by CT and MRI. Some important parameters should be obtained: the size of head circumference, brain cortex thickness, Intraventricular pressure (normal infant water for 50 ~ 60mm), lumbar puncture manometry, cerebrospinal fluid dynamics inspection . Typically, intraventricular expansion is hydrocephalus. If the fourth ventricle of normal size, only supratentorial ventricles symmetry expansion, for obstructive hydrocephalus diagnostic gold standard. If the fourth ventricle, third ventricle, lateral ventricles are expanded, consideration should be given to traffic hydrocephalus.
The treatment of children with hydrocephalus, is divided into non-surgical treatment and surgery. Non-surgical treatment for drug therapy, such as mannitol, intravenous quickly to the entry; furosemide, improve water exclusion from the urine volume; acetazolamide to inhibit the emergence of cerebrospinal fluid. Non-surgical treatment for palliative care, are generally used for mild hydrocephalus. If the result is poor, they are advised to take early surgery. The essence of surgery is excluded from the re-establishment of cerebrospinal fluid pathways. Theoretically points: cerebrospinal fluid shunt surgery; cerebrospinal fluid fistula by history, the existence of multiple bypass surgery procedure, all requiring shunt placement in vivo, such as ventriculoperitoneal shunt surgery, is about to cerebrospinal fluid through the ventricular system, the inflow to be absorbed into the abdominal cavity; addition In addition, transverse sinus ventriculoperitoneal shunt, ventricular atrial shunt, ventriculoperitoneal shunt on. Because of severe damage, the current inherited retained surgical procedures to ventriculoperitoneal shunt surgery. Cerebrospinal fluid ostomy surgery, refers to the ventricular system and the brain pool system of communication, so that cerebrospinal fluid from the ventricle into the brain pool system has been absorbed, such as the commonly used PEG endplate, in the third ventricle endplate fistulation Department will introduce a saddle cerebrospinal fluid on cisternography system. At present, the use of intraventricular endoscopic technology, ostomy surgery, has become a fashion, such as intraventricular endoscopic third ventricle at the end of surgery, such as leak-made, which greatly raised the level of minimally invasive surgery.