B. Types and causes of hydrocephalus.

1. Noncommunicating hydrocephalus (obstruction between lateral ventricles and lumbar subarachnoid space) - obstruction may occur at any location, but tends to occur most commonly at sites of normal narrowing:

a. Obstruction at foramen of Monro

1. colloid cyst of third ventricle

b. Obstruction at aqueduct of Sylvius

1. congenital malformations
2. acquired disease, e.g. stenosis due to gliosis, ependymitis or glioma

c. Obstruction at foramina of Luschka and Magendie

1. basal leptomeningitis (acquired) - usually caused by granulomatous inflammatory processes (e.g., TB, fungal infections)

2. Communicating hydrocephalus (lateral ventricles and lumbar space communicate)

a. obstructive:

1. impairment of CSF reabsorption due to leptomeningitis, subarachnoid hemorrhage or cerebral venous thrombosis

b. nonobstructive (rare)

1. overproduction of cerebrospinal fluid, e.g. by papilloma of choroid plexus or ependymoma of cauda equina

2. decreased absorption of cerebrospinal fluid

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