Hydrocephalus
Hydrocephalus is a buildup of cerebrospinal fluid (CSF) in the hollow places inside the brain. These hollow places are called ventricles. The buildup of CSF can put pressure on the brain.
Who Gets Hydrocephalus?
A child can:
be born with hydrocephalus (called congenital hydrocephalus)- get it later (called acquired hydrocephalus)
What are the symptoms:-
The symptoms of hydrocephalus can vary significantly from person to person and mostly depend on age. Conditions other than hydrocephalus can cause similar symptoms so it is important to see a doctor to receive proper diagnosis and treatment.
Infants
Signs and symptoms of hydrocephalus in infants include:
- a rapid increase in head size
- an unusually large head
- a bulge on the soft spot (fontanel) on the top of the head
- vomiting
- problems sucking or feeding
- sleepiness
- irritability
- eyes that are fixed downward (also called “sun setting”) or are not able to turn outward
- seizures
Older children, young adults, and middle-aged adults
Symptoms in older children and adults may include:
- headache
- blurred or double vision
- nausea or vomiting
- problems with balance
- slowing or loss of developmental progress like walking or talking
- vision problems
- decline in school or job performance
- poor coordination
- loss of bladder control and/or frequent urination
- difficulty remaining awake or waking up
- sleepiness
- irritability
- changes in personality or cognition including memory loss.
Older adults
Symptoms in older adults may include:
- problems walking, often described as feet feeling “stuck”
- progressive mental impairment and dementia
- general slowing of movements
- loss of bladder control and/or frequent urination
- poor coordination and balance.
Diagnosis
If a patient is suspected with hydrocephalus , Doctor may use an ultrasound to get a closer look at the brain. These tests use high-frequency sound waves to create images of the brain. This type of ultrasound can only be done in babies whose fontanel is still open.
Magnetic resonance imaging (MRI) scans can be used to look for signs of excess CSF. MRIs use a magnetic field and radio waves to make a cross-sectional image of the brain.
Computerized tomography (CT) scans can also help diagnose hydrocephalus in children and adults. CT scans use several different X-rays to form a cross-sectional image of the brain. These scans can show enlarged brain ventricles that result from too much CSF.
How is hydrocephalus treated?
Hydrocephalus can be fatal if it’s left untreated. Treatment may not reverse brain damage that’s already occurred. The goal is to prevent further brain damage. This involves restoring the normal flow of CSF. Your doctor may explore either of the following surgical options:
Shunt insertion
In most cases, a shunt is surgically inserted. The shunt is a drainage system made of a long tube with a valve. The valve helps CSF flow at a normal rate and in the right direction. Your doctor inserts one end of the tube in your brain and the other end into your chest or abdominal cavity. Excess fluid then drains from the brain and out the other end of the tube, where it can be more easily absorbed. A shunt implant is typically permanent and has to be monitored regularly.
Ventriculostomy
A procedure called a ventriculostomy can be performed as an alternative to having a shunt inserted. This involves making a hole at the bottom of a ventricle or in between ventricles. This allows CSF to leave the brain.
A Note from Dr. Vardan
Hydrocephalus is a complicated condition to diagnose, and treatment options are limited. Current long-term treatment options are restricted to surgical interventions and shunt placement. Even if the underlying disease state, such as an infection or tumor, is resolved, most patients will require surgical intervention and long-term follow-up.