Difference between revisions of "Abnormal Development - Congenital Hydrocephalus"

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Q03 Congenital hydrocephalus

International Classification of Diseases

Incl.: hydrocephalus in newborn Excl.: Arnold-Chiari syndrome (Q07.0) hydrocephalus: acquired (G91.-) due to congenital toxoplasmosis (P37.1) with spina bifida (Q05.0-Q05.4)

  • Q03.0 Malformations of aqueduct of Sylvius Aqueduct of Sylvius: anomaly obstruction, congenital stenosis
  • Q03.1 Atresia of foramina of Magendie and Luschka Dandy-Walker syndrome
  • Q03.8 Other congenital hydrocephalus
  • Q03.9 Congenital hydrocephalus, unspecified

Links: XVII Congenital Malformations | International Classification of Diseases


MRI Congenital hydrocephalus.[1]

This is a defect of cerebrospinal fliud (CSF) flow, excess fluid production or impaired fluid absorption and can be congenital or acquired. Estimated incidence of 1 in 1000 live births the condition leads to enlarged ventricles and head, separated skull cranial sutures and fontanelles. Obstruction of CSF flow can occur at any time (prenatally or postnatally) and leads to accumulation of within the ventricles. The time of onset will have different effects and should be compared to the equilivant neurological events that are occuring.

Ventricular obstruction usually occurs at the level of the cerebral aqueduct (narrowest site), but can occur elsewhere, and can be caused by viral infection or zoonotic disease.

Links: Neural Abnormalities | Ventricular Development

Neural Links: ectoderm | neural | neural crest | ventricular | sensory | Stage 22 | gliogenesis | neural fetal | Medicine Lecture - Neural | Lecture - Ectoderm | Lecture - Neural Crest | Lab - Early Neural | neural abnormalities | folic acid | iodine deficiency | Fetal Alcohol Syndrome | neural postnatal | neural examination | Histology | Historic Neural | Category:Neural

Some Recent Findings

  • Diagnosis, treatment, and long-term outcomes of fetal hydrocephalus[2] "This study analyzed 156 cases of fetal hydrocephalus treated at Osaka National Hospital from 1992 to 2011 to review current methods for diagnosing and treating fetal hydrocephalus, and for estimating its clinical outcome. This was a retrospective study of a single institute (Osaka National Hospital). Of 156 cases in total, 37% were diagnosed as isolated ventriculomegaly, 50% as another type of malformation (36 cases of myelomeningocele, six of holoprosencephaly, three of Dandy-Walker syndrome, one case of Joubert syndrome, 12 of arachnoid cyst, nine of encephalocele, three of atresia of Monro and eight of corpus callosum agenesis, and 13% as secondary hydrocephalus. Diagnoses were made between 13 and 40 weeks of gestation (average 27 weeks). Diagnosis was made before 21 weeks of gestation in 24% of cases, from the first day of 22 weeks to the sixth day of 27 weeks in 27%, and after the first day of 28 weeks in 49%. With the exclusion of 17 aborted cases and 40 cases in which the patients were too young to evaluate or lost during follow-up, the final outcome was analyzed for 90 cases. Of these, 17% of the patients died, 21% showed severe retardation, 13% moderate retardation, 26% mild retardation, and 23% showed a good outcome. The long-term outcome was mostly influenced by the basic disease and accompanying anomaly. The time of diagnosis showed no correlation with outcome. Hydrocephalus associated with arachnoid cyst, atresia of Monro, and corpus callosum agenesis, and hydrocephalus due to fetal intracranial hemorrhage, resulted in good outcomes. By contrast, holoprosencephaly, hydrocephalus associated with encephalocele, syndromic hydrocephalus, and hydrocephalus due to fetal virus infection led to poor outcomes. For accurate diagnosis and proper counseling, established protocols are important for the diagnosis and treatment of fetal hydrocephalus, including not only fetal sonography, fetal magnetic resonance imaging, and TORCH (toxoplasma, rubella, cytomegalovirus, herpes simplex) screening test, but also chromosomal and gene testing."

Arnold-Chiari syndrome

ICD - Q07 Other congenital malformations of nervous system - Q07.0 Arnold-Chiari syndrome

Chiari II malformation MRI02.jpg

Magnetic Resonance Image Sagittal T1-weighted image showing Chiari II malformation.[3]


Ventriculoperitoneal Shunt

Ventriculoperitoneal (VP) shunting is a surgical procedure that commenced in the 1960's to treat hydrocephalus and relieve increased pressure inside the skull due to excess cerebrospinal fluid (CSF) on the brain. A catheter is placed inside of the brain ventricle, the catheter is then tunneled under the skin from the scalp down into the abdominal cavity, where the other end opens into the peritoneal cavity. The catheter contains a valve (located in the skin behind the ear) that opens when pressure builds up around the brain. Complication can include: infections (8-10%), catheter blockage, over-drainage and movement of the catheter.

Links: Medline Plus article

Third Ventriculostomy

Subarachnoid cistern

An endoscopic surgical technique where a small perforation is made in the thinned floor of the third ventricle, allowing cerebrospinal fluid (CSF) out of the blocked ventricular system and into the interpeduncular cistern 9 (Cisterna interpeduncularis) that is also a normal CSF space. This was an early surgical technique, reported as early as 1922, that has revived with modern magnetic resonance imaging (MRI) and surgical endoscopic techniques that result in less damage. Due to the location of the surgery complications can include: bleeding, endocrine disfunction, and diabetes insipidus.


  1. <pubmed>22846583</pubmed>| PMC3443652 | J Med Case Rep.
  2. <pubmed>23089488</pubmed>
  3. <pubmed>23087828</pubmed>| PMC3475879 | Surg Neurol Int.



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Cite this page: Hill, M.A. (2021, December 1) Embryology Abnormal Development - Congenital Hydrocephalus. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Congenital_Hydrocephalus

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© Dr Mark Hill 2021, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G