Hydrocephalus

Overview

Hydrocephalus is a condition where there is an imbalance between the production and absorption of cerebrospinal fluid, leading to a buildup of fluid in the ventricles of the brain. This excess fluid increases the size of the ventricles, causing pressure on the brain and potentially damaging brain tissues. Hydrocephalus can occur at any age, but it is more common in infants and adults over 60. Symptoms vary depending on the age of onset and may include changes in head size, memory loss, progressive loss of thinking or reasoning skills, difficulty walking, poor coordination, and seizures. It is important to seek prompt medical attention for infants and toddlers with signs and symptoms such as a high-pitched cry, problems with sucking or feeding, unexplained vomiting, or seizures. Hydrocephalus can be caused by various factors, including abnormal development of the central nervous system, infections, tumors, bleeding in the brain, and traumatic brain injuries. If left untreated, hydrocephalus can lead to complications such as intellectual, developmental, and physical disabilities and can be life-threatening.

Understanding the disease

Symptoms

The symptoms of hydrocephalus vary by age of onset. In infants, common symptoms include changes in the head, an unusually large head, rapid increase in head size, bulging or tense soft spot (fontanel), nausea and vomiting, sleepiness or sluggishness, irritability, poor eating, seizures, eyes fixed downward, problems with muscle tone and strength. In toddlers and older children, symptoms may include headache, blurred or double vision, abnormal eye movements, abnormal enlargement of a toddler's head, sleepiness or sluggishness, nausea or vomiting, unstable balance, poor coordination, poor appetite, loss of bladder control or frequent urination, behavioral and cognitive changes, irritability, change in personality, decline in school performance, memory loss, progressive loss of other thinking or reasoning skills, difficulty walking, poor coordination or balance. For young and middle-aged adults, common symptoms include headache, sluggishness, loss of coordination or balance, loss of bladder control or frequent urge to urinate, vision problems, decline in memory, concentration, and other thinking skills that may affect job performance. In older adults, symptoms may include loss of bladder control or frequent urge to urinate, memory loss, progressive loss of other thinking or reasoning skills, difficulty walking, poor coordination or balance.

Risk Factors

The risk factors for developing hydrocephalus include:

1. Abnormal development of the central nervous system, which can obstruct the flow of cerebrospinal fluid.
2. Lesions or tumors in the brain or spinal cord.
3. Infections of the central nervous system, such as bacterial meningitis or mumps.
4. Bleeding in the brain from a stroke or head injury.
5. Traumatic injury to the brain. These factors can contribute to hydrocephalus among people of all age groups. It is important to seek prompt medical attention for any signs or symptoms associated with hydrocephalus to receive a timely diagnosis and appropriate care.

Development

Hydrocephalus can develop due to an imbalance between the production and absorption of cerebrospinal fluid. The excess fluid accumulates in the ventricles of the brain, leading to increased pressure on the brain tissues. Factors that can contribute to hydrocephalus include abnormal development of the central nervous system, bleeding within the ventricles, infections during pregnancy, lesions or tumors in the brain or spinal cord, central nervous system infections, bleeding in the brain from a stroke or head injury, and other traumatic injuries to the brain. Hydrocephalus can occur at any age, but it is more common in infants and adults over 60 years old.

Assessment and Diagnosis

Triage

You should seek emergency medical care for infants and toddlers with the following signs and symptoms of hydrocephalus:

1. Problems with sucking or feeding
2. Unexplained, recurrent vomiting
3. Seizures For other age groups, prompt medical attention should be sought for any signs or symptoms of hydrocephalus. If hydrocephalus is suspected, it is important to get a timely diagnosis and appropriate care to manage the condition effectively.

Diagnosis

A diagnosis of hydrocephalus typically involves the following steps:

1. Answers to the doctor's questions about signs and symptoms
2. A general physical examination
3. A neurological exam that assesses muscle condition, movement, well-being, and sensory function
4. Brain-imaging tests, such as ultrasound, MRI, or CT scans to detect any swelling of the brain or other conditions causing symptoms Remember to consult with a healthcare professional for personalized advice and accurate information.

Management and Treatment

Complications

Complications of hydrocephalus can include intellectual, developmental, and physical disabilities. It can also be life-threatening if left untreated. Less severe cases, when treated appropriately, may have few or no serious complications.

Home Remedies

It is important to consult with a healthcare provider for proper diagnosis and treatment of hydrocephalus.

Treatment

Treatments for hydrocephalus may vary depending on the underlying cause and severity of the condition. Surgical intervention is often necessary to restore and maintain normal cerebrospinal fluid levels in the brain. Some common treatments for hydrocephalus include:

1. Shunt surgery: A shunt is a medical device that is implanted in the brain to divert excess cerebrospinal fluid from the affected areas to a different part of the body, usually the abdomen. This helps to reduce pressure and relieve symptoms.
2. Endoscopic third ventriculostomy (ETV): This minimally invasive procedure involves creating a small hole in the floor of the third ventricle to allow the excess cerebrospinal fluid to drain away. This method is often used for infants and children and can be an alternative to shunt surgery.
3. Aqueductal stenosis repair: In some cases, the narrowing of the aqueduct can cause hydrocephalus. Surgical repair of the aqueduct can help restore normal cerebrospinal fluid flow.
4. Medications: While medications do not directly treat hydrocephalus, they may be used to manage symptoms or treat underlying conditions such as infections or inflammation.
5. Rehabilitation: Depending on the severity of symptoms and the degree of functional impairment, rehabilitation may be necessary to help patients regain lost skills or improve their overall quality of life. It is important to seek prompt medical attention for hydrocephalus symptoms and to work closely with a healthcare team to develop an appropriate treatment plan.

Preparing for medical consultation

To prepare for an appointment for hydrocephalus, here are some steps you can take:

1. Write down your symptoms: Make a list of any symptoms you've experienced, including those that may seem unrelated to hydrocephalus. Note when they began and how frequently they occur.
2. Gather your medical history: Compile information about your overall health, including any pre-existing conditions, past surgeries, and previous treatments. Also, note any family history of hydrocephalus or related conditions.
3. List your medications: Create a list of all prescription and over-the-counter medications, vitamins, and supplements you're currently taking, including doses and frequency.
4. Prepare for tests: If your doctor recommends any tests, ask about any necessary preparations, such as fasting or refraining from certain medications before the test.
5. Bring imaging results: If you have recent brain imaging, such as an MRI or CT scan, bring the results or a CD with the images to your appointment.
6. Bring a support person: Consider bringing a family member or friend to the appointment to help you remember the information discussed and provide support.
7. Prepare questions: Write down a list of questions to ask your doctor, such as the cause of your hydrocephalus, treatment options, and potential side effects. Remember to be open and honest with your doctor about your symptoms and concerns. This will help them provide the best possible care and guidance for your specific situation.