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

  1. Pascual, F. Higes
  2. Monteiro, G. Carvalho
  3. Margarit, B. Povedano
  4. Izquierdo, A. Yusta
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Ano de publicación: 2019

Título do exemplar: Enfermedades del sistema nervioso (VIII) Enfermedades cerebelosas, hidrocefalia, enfermedades metabólicas

Serie: 12

Número: 77

Páxinas: 4537-4549

Tipo: Artigo

DOI: 10.1016/J.MED.2019.05.002 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumo

Resumen La hidrocefalia es una dilatación patológica de los ventrículos cerebrales por un incremento del volumen del líquido cefalorraquídeo (LCR). Se produce generalmente por uno de dos mecanismos básicos fisiopatológicos: defecto de circulación o de reabsorción del LCR, dando lugar a los dos principales tipos de hidrocefalia: comunicante y no comunicante. Se puede producir tanto en el niño como en el adulto, predominando en el niño las causas genéticas y la patología perinatal. Las causas adquiridas se pueden producir en cualquier rango de edad. La hidrocefalia normotensiva o hidrocefalia crónica del adulto es una forma de hidrocefalia comunicante, en la cual hay un aumento patológico del volumen de los ventrículos cerebrales con presión de apertura del LCR normal. Se caracteriza por una tríada de síntomas: trastorno de la marcha, deterioro cognitivo e incontinencia de esfínteres y es potencialmente reversible mediante un shunt de derivación. La hipertensión intracraneal (HPTIC) benigna, llamada también pseudotumor cerebri, se define por unos criterios clínicos que se refieren a un cuadro de HPTIC con elevación de la presión de apertura del LCR en punción lumbar (PL), con una composición normal del mismo y descartadas otras causas de HPTIC con las pruebas oportunas. Si bien es considerado un cuadro benigno, hay riesgo de pérdida de visión permanente. El síndrome de hipotensión intracraneal tiene una etiología y presentación clínica variable que se produce, en la mayoría de casos, por fuga del LCR a través del saco tecal de forma espontánea o secundaria a PL, cirugía, traumatismos o sobredrenaje de un shunt de derivación. Cefalea ortostática, disminución de la presión de apertura del LCR y captación meníngea en resonancia magnética son las manifestaciones más características. 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.

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Fonte de datos: Dialnet