Sunday, 1 December 2013

Hydrocephalus Preventions - The Do's and Do Not's list

Hydrocephalus, also known as "water in the brain" is defined as complex and multifactorial neurological disorders of accumulation of cerebrospinal fluid (CSF) in the cavity of brain of that can lead to intracranial pressure inside the side, resulting of brain trauma, stroke, infection, tumor, etc.
Preventions
Other than structures abnormalities caused by genetic defects, accidence, etc., most acquired hydrocephalus can be prevented by enhancing the immune system in fighting against forming of free radicals causes of irregular cells growth and foreign invasion such virus and bacteria and reduce the risk of diseases cause of Hydrocephalus, such as dementia.
A. Do's and Do Not's list
 1. Mediterranean diet
If you are typical American dieter, you are at increased to develop dementia when you get older as the diet is classified as one of the most unhealthy diet in the existence, as the study of ,researchers wrote in an older population of Southern Italy with a typical Mediterranean diet, high monounsaturated fatty acids energy intake appeared to be associated with a high protection against cognitive decline. In addition, dietary fat and energy in older people seem to be risk factors, while fish consumption and cereals are found to reduce the prevalence of AD in the European and North American countries(1). Also recent research supports the hypothesis that calorie intake, among other non-genetic factors, can influence the risk of clinical dementia.(29).

2. Yoga 
Yoga is believed to have beneficial effects on cognition, attenuation of emotional intensity and stress reduction. In  the study to evaluate the effects of yoga on memory and psychophysiological parameters related to stress, comparing yoga practice and conventional physical exercises in healthy men (previously yoga-naïve). Memory tests, salivary cortisol levels and stress, anxiety, and depression inventories were assessed before and after 6months of practice. Yoga practitioners showed improvement of the memory performance, as well as improvements in psychophysiological parameters(30). Other researchers at the G.J. Patel Ayurved College, showed that Mind and body are inseparable entities and influences each other until death. Many factors such as stress, anxiety, depression, negative thoughts, unhealthy life style, unwholesome diet etc., disturb mental and physical wellbeing. Senile dementia is the mental deterioration, i.e, loss of intellectual ability associated with old age. It causes progressive deterioration of mental faculties, e.g., memory, intellect, attention, thinking, comprehension and personality, with preservation of normal level of consciousness.(31). Other suggested that the effect of stress on the immune system and examine how relaxation techniques such as Yoga and meditation could regulate the cytokine levels and hence, the immune responses during stress(31a).

3. Aging of theory of mind
In the study to predict that educational level and cognitive processing are two factors influencing the pattern of the aging of ToM at Anhui Medical University, showed that  the younger group and the older group with equally high education outperformed the older group with less education in false-belief and faux-pas tasks. However, there was no significant difference between the two former groups. The three groups of participants performed equivalently in the eyes test as well as in control tasks (false-belief control question, faux-pas control question, faux-pas control story, and Eyes Test control task). The younger group outperformed the other two groups in the cognitive processing tasks(32)

3. Moderate alcohol drinking
Moderate alcohol drinking of less than 2 cups for men and 1 cups for women are said to offers possible health benefits(3), but Binge drinking in midlife is associated with an increased risk of dementia, according to the follow-up, 103 participants had developed dementia. Binge drinking (ie, alcohol exceeding the amount of 5 bottles of beer or a bottle of wine on 1 occasion at least monthly), as reported in 1975, was associated with a relative risk of 3.2 (95% confidence interval=1.2-8.6) for dementia. Passing out at least twice as a result of excessive alcohol use during the previous year, as reported in 1981, was associated with a relative risk of 10.5 (2.4-46) for dementia in drinkers.(33). Other in the study to evaluated how (1) the number of alcoholic drinks the subjects consumed per month and (2) the drinking cessation of certain subjects were associated with their relative and absolute T, B, CD4, and CD8 lymphocyte counts and immunoglobulin A (IgA), IgM, and IgG levels, indicated that indicated that measures of immune status differed among the drinking categories and that, generally, the differences changed after adjustment for covariates. These differences consisted, as alcohol consumption increased, of higher IgA and IgM levels, relative T and CD4 lymphocytes, and the ratio of CD4 to CD8 cells, and of lower IgG levels, relative B and CD8 lymphocytes, absolute lymphocyte, and lymphocyte subset counts after adjusting for other covariates(33a).

4.  Stop Smoking or never smoke before
Smoking is a risk factor for several life-threatening diseases, but its long-term association with dementia is controversial and somewhat understudied.In a studyof a total of 5367 people (25.4%) were diagnosed as having dementia (including 1136 cases of AD and 416 cases of VaD) during a mean follow-up period of 23 years. Results were adjusted for age, sex, education, race, marital status, hypertension, hyperlipidemia, body mass index, diabetes, heart disease, stroke, and alcohol use, Dr. Rusanen M, and the team at the University of Eastern Finland, said " heavy smoking in midlife was associated with a greater than 100% increase in risk of dementia, AD, and VaD more than 2 decades later. These results suggest that the brain is not immune to long-term consequences of heavy smoking"(34).

5. Drink you tea and coffee
Caffeine in tea and coffee may enhance cognitive function acutely. In Aging and Dementia (CAIDE) study, the findings of the previous studies are somewhat inconsistent, but most studies (3 out of 5) support coffee's favorable effects against cognitive decline, dementia or AD. In addition, two studies had combined coffee and tea drinking and indicated some positive effects on cognitive functioning. For tea drinking, protective effects against cognitive decline/dementia are still less evident. In the CAIDE study, coffee drinking of 3-5 cups per day at midlife was associated with a decreased risk of dementia/AD by about 65% at late-life. coffee(35). Others in the study of Immunomodulatory effects of decaffeinated green tea (Camellia sinensis) on the immune system of rainbow trout (Oncorhynchus mykiss), showed that decaffeinated green tea in lower doses of administration could be optimum to enhance the immunity of rainbow trout(36a).


6. Eat you fruits and veggies 
Fruits and veggies contains high amounts of antioxidant which enhance the immune system in fighting against forming of free radicals in which can cause damage to the brain cells of that lead to dementia. Researchers at The Johns Hopkins University indicated that use of vitamin E and vitamin C supplements in combination is associated with reduced prevalence and incidence of AD. Antioxidant supplements merit further study as agents for the primary prevention of AD(36).

7. Regular exercise and moderate exercise for elder
In the study to evaluate to the effects of regular exercise versus a single bout of exercise on cognition, anxiety, and mood were systematically examined in healthy, sedentary young adults who were genotyped to determine brain-derived neurotrophic factor (BDNF) allelic status, indicaed that altered activity-dependent release of BDNF in Met allele carriers may attenuate the cognitive benefits of exercise. Importantly, exercise-induced changes in cognition were not correlated with changes in mood/anxiety, suggesting that separate neural systems mediate these effects(37). Other indicated that Overall, in healthy older adults, regular, particularly aerobic, exercise appears to be a friend of the immune system, helping to offset diminished adaptive responses and chronic inflammation. The possibility exists that particularly strenuous exercise may cause acute immunologic changes, such as diminished NK cell activity, which could predispose to infection in certain individuals(37a)

8.  Avoid nutritional deficiency with balance diet
Beyond our believe, in the study to highlight how an excess of dietary carbohydrates, particularly fructose, alongside a relative deficiency in dietary fats and cholesterol, may lead to the development of Alzheimer's disease and a first step in the pathophysiology of the disease is represented by advanced glycation end-products in crucial plasma proteins concerned with fat, cholesterol, and oxygen transport.(38). Dr Pae M, and the research team at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, suggested that  the need for a more in-depth, wholestic approach to determining the optimal nutritional strategies that would maintain a healthy immune system in the elderly and promote their resistance to infection and other immune-related diseases(38a).

9. Avoid environment risk of dementia(39)
Certain environment toxins produced as a result of industrialization or naturally have been linked to cognitive degenerative diseases. Researchers at the University of British Columbia in the investugation of Novel environmental toxins: steryl glycosides as a potential etiological factor for age-related neurodegenerative diseases, showed that Mice fed washed cycad flour show signs that mimic ALS-PDC, which include progressive deficits in motor, cognitive, and olfactory functions associated with neuron loss in the spinal cord, nigrostriatal system, cortex, hippocampus, and olfactory bulb. Through a series of chemical extractions of washed cycad flour, we identified steryl glycoside molecules as bioactive molecules that are neurotoxic in culture and in mice. A detailed review of this class of molecule revealed that the molecules are abundant in the environment, particularly in plants and bacteria. Lipid analysis showed that some bacteria that are associated with some forms of neurodegenerative disorders have the capacity to synthesize steryl glycosides. Furthermore, certain steryl glycosides have been found to be a cell stress mediator and may have some immunomodulary effects. Others researchers showed that Parkinson disease (PD) and Alzheimer disease (AD), are of purely genetic origin in a minority of cases and appear in most instances to arise through interactions among genetic and environmental factors and early environmental origins of neurodegenerative disease in later life. Also environment toxins can reduce the immune function in protecting against other diseases.

10. No illicit drug, please(40)
Illicit drug used may cause nervous system impairment as a result of direct and indirect effects on the integrity and function of nervous system tissue and, potentially, through immune effects. HIV-1 infection poses an additional risk of impairment, and this risk may be decreased as a result of antiretroviral drug treatment. Others researchers suggested that injection drug use represents the primary risk factor for up to 40% of patients with HIV infection. Illicit drug also can effect the CNS and weaken the immune system.

11. Prevent prolonged period of using certain drug(41)
As aging, accumulation of toxins of certain medication used to treat certain diseases, such as antidepressants, sedatives, cardiovascular drugs and anti-anxiety medications may cause increased risk of cognitive dysfunction leading to produced dementia-like symptoms. Certain medication can suppress the immune system.

12. Etc.
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Sources
(29) http://www.ncbi.nlm.nih.gov/pubmed/18466323
(30) http://www.ncbi.nlm.nih.gov/pubmed/22342535
(31) http://www.ncbi.nlm.nih.gov/pubmed/22408297
(31a) http://www.ncbi.nlm.nih.gov/pubmed/21829284
(32) http://www.ncbi.nlm.nih.gov/pubmed/22515730
(33) http://www.ncbi.nlm.nih.gov/pubmed/16222166
(33a) http://www.ncbi.nlm.nih.gov/pubmed/1356316
(34) http://www.ncbi.nlm.nih.gov/pubmed/20182054
(35) http://www.ncbi.nlm.nih.gov/pubmed/14732624
(36) http://www.ncbi.nlm.nih.gov/pubmed/22554780
(36a) http://www.ncbi.nlm.nih.gov/pubmed/21985858
(37) http://www.ncbi.nlm.nih.gov/pubmed/21402242
(37a) http://www.ncbi.nlm.nih.gov/pubmed/19001887
(38) http://healthyliving50over.blogspot.ca/2012/04/delay-dementia-causes-of-dementia.html
(38a) http://www.ncbi.nlm.nih.gov/pubmed/22500273
(39) http://healthyliving50over.blogspot.ca/2012/05/environment-toxin-causes-of-dementia.html
(40) http://healthyliving50over.blogspot.ca/2012/05/substance-abuse-causes-of-dementia.html 

Hydrocephalus - Diagnosis

Hydrocephalus, also known as "water in the brain" is defined as complex and multifactorial neurological disorders of accumulation of cerebrospinal fluid (CSF) in the cavity of brain of that can lead to intracranial pressure inside the side, resulting of brain trauma, stroke, infection, tumor, etc.
Diagnosis(28)
According to Dr. Michael Kiefer and the research team, in the study of the Differential Diagnosis and Treatment of Normal-Pressure Hydrocephalus suggested that
B.1. Diagnosis according to patient impairement
1. For patient of Gait impairment, differential diagnosis include the Characteristics of Externally rotated posture of the feet, Particular difficulty turning on the body’s long axis and Absence of apraxia.

2. For patients with Cognitive deficits/dementia, aside from reactive depression (without depressive thought content), patients with NPH generally do not have any psychiatric abnormalities. Thus, changes of mood, personality, and behavior steer the differential diagnosis toward a neurodegenerative disorder of another type. An objective examination should be performed with the aid of specific psychometric tests for the assessment of subcortical frontal lobe deficits.

Some suitable tests of this type are :
2.1 The grooved pegboard test
2.2. The Stroop test
2.3. The digit span test
2.4. The trail-making A/B test
2.5. The Rey auditory-verbal learning test
3. For patients with Incontinence 
Disturbances of bladder function in NPH result from detrusor hyperactivity owing to the partial or total absence of central inhibitory control. Patients initially suffer from increased urinary frequency (e42e44); later developments are urge incontinence and, finally, permanent urinary incontinence. Fecal incontinence is rare in NPH (2) and should arouse suspicion of another type of neurodegenerative disease. If present in a patient with NPH, it implies severe frontal subcortical dysfunction.
CSF shunting can improve bladder dysfunction in as many as 80% of iNPH patients if performed early, but in no more than 50% to 60% if performed in an advanced stage of the disease (e15, e20, e45).
4. NPH and other neurodegenerative disorders
 Findings that make NPH less likely      
4.1. Asymmetrical findings    
4.2. Cortical deficits, e.g., aphasia, apraxia, paresis     
4.3. Progressive dementia without gait disturbance     
4.5. Lack of progression of symptoms
B.2. General Diagnosis and tests 
1.  Computerized tomography (CT) or magnetic resonance imaging (MRI)
Either computerized tomography (CT) or magnetic resonance imaging (MRI) of the brain is necessary—yet, alone, never sufficient to establish the diagnosis of NPH.
2. Invasive diagnostic testing
The aim of the tests is needed to raise the prognostic accuracy above 80%
2.1. Spinal tap test: lumbar puncture with the removal of 30 to 70 mL of CSF. This can be repeated on two or three consecutive days
2.2. Continuous spinal drainage of 150 to 200 mL of CSF per day for 2 to 7 days (1– 2)
If the number of steps taken in a 10 m gait test, and the time needed to walk 10 m, are reduced by at least 20%, and/or psychometric tests show an improvement of at least 10%.
3. Other invasive tests
Long-term ICP measurement for 24 to 72 hours is performed in no more than a few centers. Special pressure waves and brain pulse amplitudes are measured Such techniques are not recommended for routine use, both because their predictive value has not yet been sufficiently documented and because they require specialized equipment and expertise.
Sources

Hydrocephalus - Misdiagnosis

Hydrocephalus, also known as "water in the brain" is defined as complex and multifactorial neurological disorders of accumulation of cerebrospinal fluid (CSF) in the cavity of brain of that can lead to intracranial pressure inside the side, resulting of brain trauma, stroke, infection, tumor, etc.
Misdiagnosis
 Because some of these symptoms may also be experienced in other disorders, sometimes normal pressure hydrocephalus is  incorrectly diagnosed and never properly treated, including
1. Tuberculosis
Neurosarcoidosis, a complication of sarcoidosis in which inflammation occurs in the brain, spinal cord, and other areas of the nervous system is observed in approximately 5% of sarcoidosis. Its common manifestations are facial palsy (50% of patients with neurosarcoidosis) and optic neuritis. Hydrocephalus is a very uncommon reported finding. Although the typical presentation of sarcoidosis such as facial palsy is not a diagnostic dilemma, more atypical presentations such as hydrocephalus with altered mentality in a tuberculosis patient can lead to a misdiagnosis(24).

2. Alzheimer's disease
Dr. Silverberg GD and scientists at the Stanford University School of Medicine in the study of Alzheimer's disease and normal-pressure hydrocephalus, suggested that if all else being equal, the initially dominant physiological change determines whether CSF circulatory failure manifests as Alzheimer's disease (AD) or as normal-pressure hydrocephalus (NPH). If CSF production failure predominates, AD develops. However, if resistance to CSF outflow predominates, NPH results. Once either disease process takes hold, the risk of the other disorder may rise. In AD, increased deposition of Abeta in the meninges leads to greater resistance to CSF outflow. In NPH, raised CSF pressure causes lower CSF production and less clearance of Abeta(25).

3. Parkinson's disease
There are several reports of cases with the characteristic clinical manifestations of normal pressure hydrocephalus--progressive dementia, gait difficulty and urinary incontinence--have been published earlier, it was Adams and Hakim who emphasized the clinical triad and the effect of shunting the cerebrospinal fluid as a means of treatment. Messert and Baker stressed that the gait disturbance had a close resemblance to the freezing gait of parkinsonism but Dr. Lobo Antunes J, and the the research team suggested that recognition of the existence of both disorders in the same patients is important since appropriate treatment of each of them led to marked improvement of their symptoms(26).

4. Creutzfeldt-Jakob disease
There is a report of  two different dementing diseases, Creutzfeldt-Jakob disease and normal-pressure hydrocephalus in a single patient. The inefficacy of a shunt procedure in this particular case, and the need of a brain biopsy in patients with normal-pressure hydrocephalus before undergoing cerebrospinal fluid shunting are stressed. A purely coincidental occurrence, or a possible aetiopathogenic relationship between both diseases are postulated(27).

5. Etc.
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Sources
(24) http://www.ncbi.nlm.nih.gov/pubmed/20717518
(25) http://www.ncbi.nlm.nih.gov/pubmed/12878439
(26) http://www.ncbi.nlm.nih.gov/pubmed/6583309
(27) http://www.ncbi.nlm.nih.gov/pubmed/6989174

Hydrocephalus - The Symptoms

Hydrocephalus, also known as "water in the brain" is defined as complex and multifactorial neurological disorders of accumulation of cerebrospinal fluid (CSF) in the cavity of brain of that can lead to intracranial pressure inside the side, resulting of brain trauma, stroke, infection, tumor, etc.
Symptoms
A.  In infancy
1. Increase in head circumference or an unusually large head size
Fluid accumulated will result in Increase in head circumference or an unusually large head size in infant regardless to the types of hydrocephalus due to bulge of the fontanelle (soft spot), Dr. Bhasker B and the research team in the reports a new finding in two siblings with primary hypomagnesaemia as a result of renal magnesium wasting, namely, rapidly increasing head size. External hydrocephalus and brain shrinkage in primary hypomagnesaemia seen on computed tomography of the brain with reversibility after magnesium treatment has not been reported previously(16).

2. Rapid eye movement sleep
In the monitor of Intracranial pressure (ICP) for 24 h in 30 hydrocephalic patients (21 infants, 9 children) showed that during sleep related to a period of rapid eye movement (REM) fairly regular steep-rising waves of raised ICP recurred every 50-75 min, decreasing slowly to previous levels in 25-40 min(17).

3. Sleepiness, Irritability, Sunsetting of the eyes, Seizures are most common symptoms in infant(18)

4. Other symptoms
Dr. Kirkpatrick M and scientists at the Royal Hospital for Sick Children, in the study of Symptoms and signs of progressive hydrocephalus, showed that in the clinical features of 107 cases of children with hydrocephalus and measured raised intraventricular pressure were analysed retrospectively. Fifty one children had recently been diagnosed as having hydrocephalus, and the remainder had had shunts injected to direct the cerebrospinal fluid. The most common symptoms in the group were vomiting, behavioural changes, drowsiness, and headaches. The most common clinical signs were inappropriately increasing occipitofrontal head circumferences, tense anterior fontanelles, splayed sutures, and distension of the scalp veins. Half the infantile cases of hydrocephalus were without symptoms, and a quarter of the cases with cerebrospinal fluid shunts and measured raised intraventricular pressure were without signs. There were no fewer than 33 different clinical signs including several unusual ones, such as macular rash and sweating. We believe that the presentation of hydrocephalus with raised intraventricular pressure is sufficiently variable, unusual, or even absent to justify the direct measurement of intracranial pressure(19).


8. Etc.

B.  Children and adults
Beside some symptoms mentioned in the infant section, Children and adults with the disease may also be experience other symptoms because of the head can no longer expand to accommodated to the accumulation of the fluid
1. The most common symptoms in the group were vomiting, behavioural changes, drowsiness, and headaches. The most common clinical signs were inappropriately increasing occipitofrontal head circumferences, tense anterior fontanelles, splayed sutures, and distension of the scalp veins(19).

2. Diplopia, headaches, and papilledema
Hydrocephalus can also cause symptoms of diplopia, headaches, and papilledema, There is a report of a 48-year-old woman was admitted to the hospital because of diplopia, headaches, and papilledema. Imaging revealed cysts in the fourth ventricle and spinal canal(20)


3. Headache, hearing difficulty and blurred vision
Headache and blurred vision are also associated with symptoms of hydrocephalus. There is a report of a
patient of 25-year-old female, admitted to the department of otorhinolaryngology with complaints of hearing difficulty, headache and blurred vision(21).

4. Other symptoms
Dr. Kubo Y and research team at the Osaka University Graduate School of Medicine, in the study of Validation of grading scale for evaluating symptoms of idiopathic normal-pressure hydrocephalus, showed that the interrater reliability of this scale was high. The iNPHGS cognitive domain score significantly correlated with the cognitive test scores, including the Mini-Mental State Examination (MMSE), the gait domain score with the Up and Go Test and Gait Status Scale scores, and the urinary domain score with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score. The MMSE, Gait Status Scale and ICIQ-SF scores significantly improved in patients whose iNPHGS scores improved after CSF tapping but not in those whose iNPHGS scores did not improve after CSF tapping. Fourteen of the 38 patients received shunt operations. In these 14 patients, changes in the iNPHGS cognitive and urinary domains after CSF tapping were significantly associated with the changes after the shunt operation(22). Other found that the most frequently observed neuropsychiatric symptom in the iNPH patients was apathy followed by anxiety and aggression. No symptom was more prevalent or more severe in iNPH than in AD. The severity of cognitive impairment was correlated with both aberrant motor activity and apathy(23).

5. Etc. 


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Sources   
(16) http://www.ncbi.nlm.nih.gov/pubmed/10569968
(17) http://www.ncbi.nlm.nih.gov/pubmed/183936
(18) http://pediatrics.about.com/cs/conditions/a/hydrocephalus_2.htm
(19) http://www.ncbi.nlm.nih.gov/pubmed/2923462
(20) http://www.ncbi.nlm.nih.gov/pubmed/22591299
(21) http://www.ncbi.nlm.nih.gov/pubmed/2046855
(22) http://www.ncbi.nlm.nih.gov/pubmed/18025828
(23) http://www.ncbi.nlm.nih.gov/pubmed/19996513

Hydrocephalus - The Causes and risk factors

Hydrocephalus, also known as "water in the brain" is defined as complex and multifactorial neurological disorders of accumulation of cerebrospinal fluid (CSF) in the cavity of brain of that can lead to intracranial pressure inside the side, resulting of brain trauma, stroke, infection, tumor, etc.
The Causes and risk factors
A. Causes
Although the actual causes of  Hydrocephalus is unknown, some researchers suggested that
1. Genetic defect
Congenital hydrocephalus id associated with dysfunctional motile cilia represent the underlying pathogenetic mechanism in 8 of the 12 lines (Ulk4, Nme5, Nme7, Kif27, Stk36, Dpcd, Ak7, and Ak8).(3). Other researchers suggested that Although hydrocephalus is usually a sporadic disorder, there exist some rare but well delineated syndroms, in which recurrence is to be expected. The here presented Bickers-Adams-Syndrome of sex-linked hydrocephalus is caused by congenital aqueductal stenosis(4).

2.  Meningitis
Hydrocephalus is associated with the complications of tuberculous meningitis (TBM) occurred in up to 85% of children with the disease. It is more severe in children than in adults. It could be either of the communicating type or the obstructive type with the former being more frequently seen(5).

3. Neural tube defect
Congenital hydrocephalus is a relatively uncommon abnormality in population malformation surveys accounting for between four and ten out of every 10,000 births. In the review of Sixty cases of  28 with NTD (group 1) and 32 without NTD (group 2). The groups were similar in terms of maternal and child variables at birth and hospitalization days during the 1st year of life. The mortality (including intrauterine deaths and deaths of babies with malformations incompatible with life that characterize a very poor prognosis) until 1 year of age was 36% in group 1 and 59% in group 2 (p = 0.077). The rate of cardiac malformations was higher in the group without NTD (p = 0.015). The length of hospital stay after birth (1st admission) was significantly higher in the group with NTD (p = 0.007)(6).

5. Intraventricular hemorrhage
Intraventricular hemorrhage and posthemorrhagic hydrocephalus are common causes of neonatal morbidity and mortality among preterm and low-birth weight infants (PT-LBWIs), but Intraventricular hemorrhage in PT-LBWIs remains a significant problem, particularly when it is associated with PHH leading to long-term neurological impairment and decreased survival rate(7).

6. PTB Deficiency
Polypyrimidine tract-binding protein (PTB) is a well-characterized RNA-binding protein and known to be preferentially expressed in neural stem cells (NSCs) in the central nervous system. Dr. Shibasaki T and the research team at the Center for Experimental Medicine and Systems Biology. showed that PTB depletion in the dorsal telencephalon is causally involved in the development of HC and that PTB is important for the maintenance of AJs in the NSCs of the dorsal telencephalon(8).

6.  Tumors
Tumor-associated hydrocephalus is common in primary pediatric brain tumors. In the study of a total of 56.7% of cases presented hydrocephalus, including hydrocephalus that occurred at tumor diagnosis (51.5%), and hydrocephalus developed after tumor diagnosis (5.1%). At tumor diagnosis, the hydrocephalus was mainly obstructive type (98%) and rarely communicating type (1.9%). Definite shunting procedures in this series comprised of ventriculoperitoneal (VP) shunt in 54.4%, endoscopic third ventriculostomy (ETV) in 10.9%, subduroperitoneal (SP) shunt in 4.8%, septostomy in 0.7%, lumboperitoneal shunt in 0.6%, and ventriculoatrial shunt in 0.1% of patients with hydrocephalus(9).

7. Traumatic head injury
Post-traumatic hydrocephalus (PTH) is considered a frequent complication after severe head injury (HI). External hydrocephalus is a well-established entity in infants which is benign and usually resolves without shunting [1, 2]. The term “External Hydrocephalus” has also been used to describe the presence of extra ventricular cerebrospinal fluid (CSF) collections accompanied by hydrocephalus, particularly in cases of adults suffering from aneurysmal subarachnoid hemorrhage and severe head injuries [3–6]. Several other terms have been used to describe this entity [7] which has lead to confusion about this disease(10).


8. Subarachnoid hemorrhage 
Acute hydrocephalus as a consequence of subarachnoid hemorrhage is a relatively frequent problem. Dr. Suarez-Rivera O. at the National Institute of Neurology and Neurosurgery, Mexico City, indicated that that acute hydrocephalus is present in 20% of patients with subarachnoid hemorrhage. One third of them may be asymptomatic on admission; 50% of those who have clinical hydrocephalus recover spontaneously within the first 24 h(11)

9. Etc.

B. Risk factors
1. Family history

Family studies suggested that the risk to siblings of a child with uncomplicated congenital hydrocephalus, where the anatomical site is not specified, is about 1 in 50 (1 in 40 for males, 1 in 80 for females). With aqueduct stenosis, the risk to brothers of affected boys is 1 in 22, to sisters only 1 in 50. The risks to siblings of sisters is less. Probably less than 2% of uncomplicated hydrocephalus has an X-linked basis and such an aetiology should be suspected if the special clinical features are present, there is more than one male sibling affected, or there are affected male relatives on the mother's side(12).

2. Nontumoral aqueductal stenosis, nontectal tumor and tectal glioma
Hydrocephalus was most commonly due to nontumoral aqueductal stenosis (43%), nontectal tumor (25%), or tectal glioma (13%). Five patients (16%) had multicystic/loculated hydrocephalus(13).

3. Preterm and low-birth weight infants
Preterm and low-birth weight infants are associated with increased risk of  intraventricular and/or periventricular hemorrhage (IVH and PVH, respectively) of that can lead to Hydrocephalus(14).

4. Other factors
Although the precise nature of the neuropsychological deficits in hydrocephalus are not completely known, several factors such as etiology, raised intracranial pressure, ventricular size, and changes in gray and white matter tissue composition as well as shunt treatment complications have been shown to influence cognition. In fact, the presence of complications and other brain abnormalities in addition to hydrocephalus such as infections, trauma, intraventricular hemorrhage, low birthweight, and asphyxia are important determinants of the ultimate cognitive status, placing the child at a high risk of cognitive impairment(15).

5. Etc.
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Sources
(4) http://www.ncbi.nlm.nih.gov/pubmed/3907171
(5) http://www.ncbi.nlm.nih.gov/pubmed/19770534
(6) http://www.ncbi.nlm.nih.gov/pubmed/17934294
(7) http://www.ncbi.nlm.nih.gov/pubmed/16256848
(8) http://www.ncbi.nlm.nih.gov/pubmed/22705452
(9) http://www.ncbi.nlm.nih.gov/pubmed/21928036
(10) http://www.hindawi.com/journals/crim/2010/743784/
(11) http://www.ncbi.nlm.nih.gov/pubmed/9586937
(12) http://www.ncbi.nlm.nih.gov/pubmed/6524107
(13) http://www.ncbi.nlm.nih.gov/pubmed/22702328
(14) http://www.ncbi.nlm.nih.gov/pubmed/22116446
(15) http://www.ncbi.nlm.nih.gov/pubmed/11883667

Hydrocephalus - The Types

Hydrocephalus, also known as "water in the brain" is defined as complex and multifactorial neurological disorders of accumulation of cerebrospinal fluid (CSF) in the cavity of brain of that can lead to intracranial pressure inside the side, resulting of brain trauma, stroke, infection, tumor, etc.

I. Types of Hydrocephalus
1. Congenital hydrocephalus
Congenital hydrocephalus is a condition presented at birth as a result of genetic defect or abnormal fetal development. In the study to illustrate the value of knockout mice in identifying genetic factors involved in the development of congenital hydrocephalus, showed that dysfunctional motile cilia represent the underlying pathogenetic mechanism in 8 of the 12 lines (Ulk4, Nme5, Nme7, Kif27, Stk36, Dpcd, Ak7, and Ak8)... characterization of mouse models can enhance understanding of important cell signaling and developmental pathways involved in the pathogenesis of hydrocephalus(1). At least 43 mutants/loci linked to hereditary hydrocephalus have been identified in animal models and humans. Up to date, 9 genes associated with hydrocephalus have been identified in animal models. In contrast, only one such gene has been identified in humans. Most of known hydrocephalus gene products are the important cytokines, growth factors or related molecules in the cellular signal pathways during early brain development(2).

2. Acquired hydrocephalus
Acquired hydrocephalus is a condition developed after birth as a result of injure or diseases.

3. Communicating hydrocephalus or non-obstructive hydrocephalus,
Communicating hydrocephalus is defined as condition as the cerebrospinal fluid (CSF) can still flow between the ventricles.

4.  Non communicating hydrocephalus or obstructive hydrocephalus
Non communicating hydrocephalus is defined as a condition as the cerebrospinal fluid (CSF)  is blocked and can not flow between the ventricles.

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/21746835
(2) http://www.ncbi.nlm.nih.gov/pubmed/16773266 

The Article and Polycystic Ovarian Syndrome's research


Permanently Eliminate All Types of Ovarian Cysts and PCOs Within 2 Month, Click here

 I. The article 
Polycystic Ovarian Syndrome is defined as endocrinologic diseases caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries as resulting of enlarged ovaries, leading to hormone imbalance( excessive androgen), resulting in male pattern hair development, acne,irregular period or absence of period, weight gain and effecting fertility. It effects over 5% of women population or 1 in 20 women.

Ovarian cysts affect women of all ages, especially during a woman's childbearing years. Most ovarian cysts are functional and benign but some can become cancerous. Some ovarian cysts can cause bleeding and pain such as endometriomas/chocolate cysts and surgery is required for any cyst larger than 5 cms in diameter or if the cyst has interfered with the extruding of mature follicle. Traditional Chinese medicine defines ovarian cyst is a medical condition caused by excess- dampness (caused by blood and fluid stasis) accumulated in the abdomen and gradually coalesces into phlegm, that can manifest as that can manifest as ovarian cysts or various kinds, including chocolate cysts. In conventional medicine, ovarian cysts is defined as a collection of fluid, surrounded by a very thin wall, within an ovary.

Over the years as health article writer and researcher, I have received hundreds if not thousand of enquiry from women who have suffered from the affects of Ovarian cysts and Polycystic Ovarian Syndrome. Through the extensive research, some articles were written(1-5)) with an aim to help enquirers to understand more about the diseases, how they can manage the symptoms as well as treatments in conventional and holistic medicine perspective. Many recommendations have been given in herbal treatments from  traditional Chinese and herbal medicine with medical studies proofs(6 -10). Unfortunately, all these types of treatment are required the correct differentiation of the diseases with specialists. Women who listened to these approaches have complained that they ended up with thousands of dollars expenses and spent lengthy time in the herbal specialist office before the diseases were cured. Women with less financial secure were recommended to a self help holistic treatment, the Ovarian Cyst Miracle written by Carol Foster with the same successful result.
Many women who know me through their friends recommendation and have tried the approaches insisted that the self help holistic treatment is the best as it is less financial burden (only $40) but to get rid of  the Ovarian Cysts and and PCOs within 2 months, determination to follow the recommendations of the book is absolutely necessary. I, therefore recommend this book to all women who have suffered from the affects of Ovarian Cysts and PCOs to follow the approaches to eliminate all Ovarian Cysts and PCOS issues safely and naturally and regain the quality of life. Kyle J. Norton

All right reserves. Any reproduction of the article must have all link intact.


Sources
Polycystic Ovarian Syndrome
1. In Conventional Medicine Perspective
2.In Traditional Chinese Medicine Perspective 
3. In Weight Loss Perspective 
Ovarian Cysts
4. Ovarian Cysts In Conventional Medicine Perspective
5. Ovarian Cysts In Traditional Chinese Medicine Perspective
6. [Clinical observation on treatment of 43 women with polycystic ovary syndrome based on syndrome differentiation]
7. [Observation on therapeutic effect of acupuncture combined with chinese herbs on polycystic ovary syndrome of kidney deficiency and phlegm stasis type].
8. Treating adolescent ovarian cysts with Chinese herbs: a case report
9. Treating ovarian cysts with Chinese herbs: a case report.
10. Progress of integrative Chinese and Western medicine in treating polycystic ovarian syndrome caused infertility

II. The research
Permanently Eliminate All Types of Ovarian Cysts and PCOs Within 2 Month, Click here

Polycystic Ovarian Syndrome is defined as endocrinologic diseases caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries as resulting of enlarged ovaries, leading to hormone imbalance( excessive androgen), resulting in male pattern hair development, acne,irregular period or absence of period, weight gain and effecting fertility. It effects over 5% of women population or 1 in 20 women.

1. Adipose tissue hormones and appetite and body weight regulators in insulin resistance 
2. Physiopathology review of Polycystic ovary syndrome
3. Altered adipocyte function in polycystic ovary syndrome
4. Adiponectin and resistin serum levels in women with polycystic ovary syndrome
5. Cardiovascular Risk in Women With PCOS
6. Rosiglitazone treatment increases plasma levels of adiponectin and decreases levels of resistin in overweight women with PCOS
7. Genetic aspects of polycystic ovary syndrome
8. Polycystic ovary syndrome in men
9. Obstetric complications in women with polycystic ovary syndrome
10. The molecular phenotype of polycystic ovary syndrome (PCOS) theca cells and new candidate PCOS genes 
11. Some new thoughts on the pathophysiology and genetics of polycystic ovary syndrome
12. Can anti-mullerian hormone predict the diagnosis of polycystic ovary syndrome?
13. Dietary composition in the treatment of polycystic ovary syndrome
14. The treatment of infertility in polycystic ovary syndrome
15. N-acetyl cysteine in clomiphene citrate resistant polycystic ovary syndrome
16. The treatment of infertility in polycystic ovary syndrome
17. Polycystic ovary syndrome, obesity and reproductive implications
18. Impact of obesity on reproduction in women with polycystic ovary syndrome
19. The role of obesity in the development of polycystic ovary syndrome
20. Alterations in thyroid function among the different polycystic ovary syndrome phenotypes
21. Mood and sexual function in polycystic ovary syndrome
22. Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome
23. Polycystic ovary syndrome--a medical condition but also an important psychosocial problem
24. Polycystic ovary syndrome and mental health
25. Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome
26. Polycystic ovary syndrome--a medical condition but also an important psychosocial problem
27. The treatment of infertility in polycystic ovary syndrome
28. How significant are environmental estrogens to women
29. Polycystic ovary syndrome and mental health
30. Psychological implications of infertility in women with polycystic ovary syndrome

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