Global Ischemic in A 3-Months-Old Child with Hydrocephalus : A Case Report of Good Outcome

Abstract

Introduction. Ventriculomegaly causes compression within the cranial vault, which increases intracranial pressure and leads to severe brain damage. Usually progressive. if untreated, may be fatal. Case. 3-month-old male child with increasement of head circumference for 2 months. Fever, cough, cold, vomiting, seizure was not found. MRI show extensive dilatation of ventricular system wide-open foramen of Luschka and Magendie with thinning of cerebral cortex and also global ischemic hypoxia. Discussion. The CBF is regulated by the Monroe-Kellie doctrine which state that space of the cranial cavity is fixed in volume. Congenital hydrocephalus occurs in one in 500-1000 babies born in the United States. Lipid peroxides, formed by oxygen free radical damage to membranes, have been detected in hydrocephalic brains by detection of thiobarbituric acid reactive substances. The mechanism of periventricular axon damage includes calcium mediated activation of proteolytic calpains that damage cytoskeletal proteins, similar to the processes that follow acute traumatic or ischemic injury. The gold standard permanent treatment for hydrocephalus is CSF diversion by placement of a shunt. A shunt has three basic component parts: a ventricular catheter placed in the lateral ventricle, a valve regulating the flow of CSF out of the brain, and a distal catheter that terminates in a cavity. The most common shunt, a ventriculoperitoneal shunt (VPS), has been well accepted since its inaugural use. Surgical treatment is associated with a 50% reduced risk of death overall