Hydrocephalus – Symptoms, Diagnosis and Treatment
Summary: Hydrocephalus is dangerous as the flow of cerebrospinal fluid is blocked and it starts accumulating in the brain. The symptoms are quite painful and must be treated immediately to prevent further damage to the brain tissues.
Hydrocephalus is a health problem that arises due to excess accumulation of fluid in the brain. Hydrocephalus was once called the ‘water of the brain’ and today we know that that ‘water’ is actually cerebrospinal fluid (CSF). It is a clear fluid surrounding the spinal cord and the brain. The ventricles (spaces in the brain) widens abnormally due to the excessive accumulation of CSF. As a result the brain tissues are in danger because of the potentially harmful pressure caused by the widening of the ventricles. The four ventricles are connected by narrow passages through which the CSF flows. Inherited genetic abnormalities may result in Hydrocephalus. Aqueductal stenosis is one such cause. Developmental disorders like Encephalocele and conditions associated with neural tube defects including spina bifida may also be the cause.
Hydrocephalus – What Causes It?
Premature birth defects such as intraventricular hemorrhage, diseases like meningitis, traumatic head injury, tumors or subarachnoid hemorrhage that block the ventricle exit of CSF to the cisterns are also causes of Hydrocephalus. The symptoms vary according to age, individual differences in tolerance to the condition and disease progression. In children, a very common symptom is a fast increase in head circumference resulting in an unusually large head size. Sleepiness, seizures, downward deviation of eyes, vomiting and irritability are also quite common.
Some of the symptoms in adults are vomiting, severe headache, papilledema, nausea, blurred vision, problems with balance, sunsetting of eyes, lethargy, irritability, urinary incontinence and slowing or loss of developmental progress and memory loss.
Clinical neurological evaluation and cranial imaging techniques like CT scan, ultrasonography, pressure monitoring techniques and magnetic resonance imaging (MRI) can diagnose Hydrocephalus. Factors like clinical presentation, patient’s age and existing abnormalities of brain and spinal cord are taken into account by physicians to select the appropriate diagnostic procedure. A shunt system (sturdy plastic tube, catheter and a valve) is very often inserted surgically and that diverts the CSF flow from the CNS to another area of the body where it is absorbed as a regular circulatory process. Another procedure to treat Hydrocephalus is the third ventriculostomy. In this method, a neuroendoscope (a small camera using fiber optic technology to detect difficult surgical areas) helps the surgeon to view the ventricular surface. A tiny hole is made on the surface of the third ventricle allowing the CSF to first bypass the obstruction and then flow towards the surface of the brain thus releasing the pressure.