Patología del líquido cefalorraquídeo. Hidrocefalia, pseudotumor cerebral y síndrome de presión baja

Abstract

Hydrocephalus is the pathological enlargement of the brain ventricles caused by accumulation of cerebrospinal fluid (CSF). Two basic pathophysiological mechanisms are involved: impairment of CSF circulation or resorption; causing the two main types of hydrocephalus: communicating and noncommunicating hydrocephalus. Appears both in childhood and adulthood. Genetic causes and perinatal pathology dominate in children. Acquired causes are involved in any age range. Normal pressure hydrocephalus or chronic adult hydrocephalus is a type of communicating hydrocephalus, in which ventricles of the brain enlarge with normal CSF opening pressure. Clinically is characterized by the triad of abnormal gait, sphincter incontinence and cognitive impairment. In most cases, the placement of a cerebrospinal fluid shunt revert it. Idiopathic intracranial hypertension (IIH) or pseudotumor cerebri, is clinically characterized by an increased CSF opening pressure in lumbar puncture (LP), the composition of the cerebrospinal fluid is normal, and no other cause of intracranial hypertension are identified. Although is considered benign, permanent blindness can occur. Intracranial hypotension syndrome has a diverse etiology and variable clinical presentation; usually, spontaneous or secondary (LP, surgery, trauma or shunt) CSF leaks through thecal sac causes it. The most characteristic symptoms are orthostatic headache, lower CSF opening pressure and meningeal contrast enhancement.