Hydrocephalus

Hydrocephalus – General Information

Hydrocephalus (also known as “water in the brain”) is the abnormal accumulation of the cerebrospinal fluid (also abbreviated CSF) in the ventricles of the brain. This fluid accumulation may lead to an increase intracranial pressure inside the skull which leads to a progressive enlargement of the head and in almost all of the cases to mental disability. Hydrocephalus appears when the cerebrospinal fluid blocks in the ventricles or in the subarachnoid space. In a person who does not have this medical condition the cerebrospinal fluid circulates continuously through the ventricles and brain and through the spinal cord. In a person who has this medical condition the fluid accumulates in the ventricles and the skull usually becomes enlarged due to the volume of the fluid which is pressing the brain. In other cases, Hydrocephalus may be the result of an overproduction of the cerebrospinal fluid, of a congenital malformation which blocks the normal drainage of this fluid, from head injuries, or from head infections. In most of the cases the children and infants which are suffering from this medical condition have a very large head (this enlargement of the person’s head is due to the pressure of the fluid which causes the skull bones to bulge outwards their juncture areas). The compression of the brain due to the accumulation of the fluid usually leads to convulsions and event to mental retardation. If this medical condition is discovered and treated at time by the doctors or health care providers it does not lead to intellectual impairment.

Hydrocephalus – Symptoms

It is well known the fact that any medical disorder (including Hydrocephalus) can trigger a variety of symptoms. Therefore, some of this medical condition's most uncommon symptoms have not been listed (mentioned) here. This is why we strongly recommend you to contact your personal health care provider whenever you develop any unusual, bothersome or unpleasant symptoms. Your personal physician will be able to tell you if you are suffering from Hydrocephalus or from any other medical disorder. Here is a list of the most common symptoms that a person who suffers from Hydrocephalus, may experience. The symptoms which appear due to the increased pressure inside the skull resemble: headaches, vomiting, nausea, sleepiness, papilledema and even coma. The high intracranial pressures usually lead to other life threatening conditions. Some of the patients may also develop the triad (the Hakim triad) which includes: dementia, urinary incontinence and gait instability which are also due to the intracranial pressure. This medical condition may lead to focal neurological deficits (this neurological deficit may include, for example, the abducens nerves). The abducens nerves vertical gaze palsy leads to the Parinaud syndrome which is due to the compression of the quadrigeminal nerves. In children the symptoms of this medical condition include: cephalomegaly, a bulging forehead, a thin and transparent scalp, prominent fontanelles and downward gaze. Patients may also have abnormal reflexes which are due to the compression of different nerve zones localized in the brain, a slow heart beat, slow respiratory rate, irritability and vision problems.

Hydrocephalus – Treatment

The doctors or personal health care providers may diagnose Hydrocephalus even in the unburned children through a routine prenatal ultrasound control. Hydrocephalus may also be diagnosed by the doctors or health care provider in infancy or in early childhood, because in these periods the head is constantly measured because the children’s growth is monitored. If a baby’s head is larger or if it grows more rapid than of the other children, the doctor usually recommend the parents an ultrasound of their baby’s head. If the ultrasound’s results are abnormal then the doctor will do further investigations in the child. In older children and adults who are suspected of Hydrocephalus or who develop the signs and symptoms of this medical condition the doctor will recommend them to do a physical and neurological examination, a computerized tomography (also abbreviated CT), a magnetic resonance imaging  (also abbreviated MRI) which usually give the doctors detailed photographs of the patient’s brain.

The most common treatment which the doctors or personal health care providers usually prescribe in the patients who are suffering from Hydrocephalus is surgery. During surgery the doctor inserts a drainage system which is called shunt. This drainage system has a long flexible tube with a valve which keeps the fluid from the brain to flow in the normal direction. One of the tube’s ending is inserted in the patient’s brain’s ventricle. The rest of the tube is tunneled under the skin to other parts of the body where the excess quantity of the cerebrospinal fluid is absorbed. Such parts of the body can be the heart (one of its chambers) or the abdominal cavity. The people who have this medical condition need these shunts for the rest of their lives, and during their live they will need several surgical interventions in order to insert longer tubes which match the person’s growth.  Patients must go and see a doctor at least once a month to see if the tubes have not become infected or blocked. Ventriculostomy is another surgical option which is used in the cases in which the patients have an obstruction between the ventricles. During this surgery the doctor cuts one of the ventricles making a hole in its bottom, in order for the cerebrospinal fluid to flow to the normal area of the absorption.

The severity of this medical condition depends on the age of the patient and the course the disease has. If this medical condition is in an advanced stage at birth, the new born will have brain damage and physical disabilities. In the cases in which this medical condition is not in an advanced stage at birth, the child has the chance with a proper treatment to live a normal life. This is why it is very important for pregnant women to get prenatal care in order to reduce the risk of a premature labor, to protect the child after birth from head injuries, and to keep the child’s vaccines up to date, in order to prevent the apparition and development of Hydrocephalus.