Hydrocephalus
What is hydrocephalus?
Hydrocephalus is an abnormal buildup of fluid within the brain. The term hydrocephalus comes from the Greek words “hydro,” meaning water, and “cephalus,” meaning head. It was once known as “water on the brain.” The “water” is actually cerebrospinal fluid (CSF), a clear, colorless fluid surrounding the brain and spinal cord.
Normally, CSF flows through areas in the brain called ventricles, serving as a nutrient delivery and waste removal system. CSF bathes and cushions the brain and spinal cord from injury and is reabsorbed into the bloodstream. When the normal flow or absorption of CSF is blocked, it results in a buildup of CSF, causing the ventricles to enlarge and increasing pressure inside the head. This pressure can impair brain function.
Who can get hydrocephalus?
Hydrocephalus can affect anyone, with one to two out of every 1,000 babies in the United States born with the condition. It can also impact older children and adults of any age.
What are the different types of hydrocephalus?
The four main types of hydrocephalus are:
Communicating hydrocephalus: CSF flow is blocked after it leaves the ventricles, preventing free flow.
Non-communicating hydrocephalus (obstructive hydrocephalus): CSF flow is blocked along one or more narrow passages connecting the ventricles.
Normal pressure hydrocephalus (NPH): CSF buildup causes ventricles to enlarge without a significant increase in pressure, occurring mostly in the elderly.
Hydrocephalus ex-vacuo: Results from brain damage due to injury or stroke, with CSF filling the space left by shrinking brain tissue, usually without increased pressure.
What causes hydrocephalus?
Hydrocephalus can either be present at birth (congenital) or develop later in life (acquired). Congenital hydrocephalus may result from: Spina bifida and other neural tube defects.
Narrowing of the passage between brain ventricles (aqueductal stenosis).
Complications of premature birth.Infections during pregnancy.
Acquired hydrocephalus can develop after birth due to:
- Head trauma.
- Stroke.
- Brain or spinal cord tumors.
- Infections like meningitis.
What are the symptoms of hydrocephalus?
Diagnosis and Tests
Hydrocephalus is diagnosed through a neurological evaluation and brain imaging techniques such as ultrasounds, CT scans, or MRI. Other tests for adults may include spinal taps, intracranial pressure monitoring, and fundoscopic exams.
Management and Treatment
Can hydrocephalus go away on its own?
No, untreated hydrocephalus can be fatal. Timely diagnosis and treatment are essential for effective recovery.
Is hydrocephalus treatable?
Yes, it is treatable with surgery. The two primary surgical treatments are:
Shunt:
A flexible tube is placed in the brain to drain excess CSF to another body area for absorption.
Endoscopic third ventriculostomy (ETV):
A small hole is made in the third ventricle to allow CSF to flow normally. This is usually performed on children over the age of 2.
What are the complications of hydrocephalus treatment?
Shunts can break, fail, or become infected, necessitating further surgery. An ETV can close at any time, posing danger. Symptoms of shunt failure or ETV closure include headaches, vision problems, nausea, fatigue, neck or shoulder soreness, seizures, redness along the shunt area, and low fever.
Outlook / Prognosis
With surgery and monitoring, many people with hydrocephalus lead normal lives. However, the condition and surgical complications vary greatly among individuals. It’s essential to work with healthcare providers for optimal care. Children with hydrocephalus require specialized care to ensure positive cognitive and physical development outcomes.
FAQs
The primary treatments for hydrocephalus involve surgical procedures. The most common method is the insertion of a shunt, a flexible tube that helps drain excess cerebrospinal fluid (CSF) from the brain to another part of the body where it can be absorbed. Another option is an endoscopic third ventriculostomy (ETV), where a small hole is made in the floor of the third ventricle to allow CSF to flow normally.
While many people undergo successful hydrocephalus treatment, there are potential risks and complications. Shunts can malfunction, become blocked, or get infected, necessitating additional surgeries. ETV procedures can also close over time, requiring further intervention. Regular monitoring and check-ups with a healthcare provider are essential to manage these risks
At present, there is no lasting cure for hydrocephalus. Treatment focuses on managing the condition by alleviating symptoms and preventing complications. With proper treatment, many individuals can lead normal lives, but ongoing medical supervision is typically required to monitor the effectiveness of the treatment and address any issues that arise.
