What is hydrocephalus?

Hydrocephalus is primarily associated with a build-up of fluid on the brain. The condition was previously recognised as water on the brain, despite the fact that the fluid is in fact cerebrospinal fluid rather than water. Cerebrospinal fluid is a clear liquid which surrounds both the brain and the spinal cord. Accumulation of cerebrospinal fluid causes areas in the brain known as ventricles to become abnormally dilated and this leads to an increase in pressure on certain tissues in the brain.

Hydrocephalus can be either congenital or acquired. Congenital means that the condition is there at birth. Congenital hydrocephalus can be caused by conditions such as encephalocele and spina bifida or genetic abnormalities, while acquired hydrocephalus can develop shortly after birth or later in life. Acquired hydrocephalus can affect people of all ages.

Symptoms of hydrocephalus

The signs of hydrocephalus vary according to the individual, including the age of the individual and their tolerance level to the increased level of cerebrospinal fluid.

In infants, the most common symptom is a large head and there may also be a rapid increase in the circumference of the head.

In adults and older children the common symptoms include:

  • Headaches
  • Vomiting
  • Nausea
  • Difficulties associated with balance and coordination
  • Papilloedema (inflammation of the optic disk located in the optic nerve)
  • Delayed development
  • Drowsiness, tiredness and lethargy
  • Irritability
  • Memory loss
  • Changes in personality
  • Urinary incontinence

Diagnosis of hydrocephalus

Hydrocephalus is identified by means of clinical tests and neurological assessment. Imaging techniques including MRI (magnetic resonance imaging) and CT (computerised tomography) scans and ultrasounds can be used to diagnose hydrocephalus.

Treatment for hydrocephalus

The most common treatment for hydrocephalus is the insertion of a shunt structure in the brain. This redirects the flow of cerebrospinal fluid from the central nervous system to a different section of the body. It can then be absorbed through the natural circulation process. Some patients may receive treatment using an alternative procedure known as third ventriculostomy. This procedure involves making a small hole in the floor of the third ventricle, which enables the cerebrospinal fluid to flow freely to the site of absorption and reduce the risk of build-up.

Prognosis for hydrocephalus

It is tricky to predict the prognosis of hydrocephalus because the condition affects people in different ways, people respond differently to treatment and other conditions or defects are often associated with hydrocephalus. The prognosis can also be affected by the time of diagnosis.

Signs of normal pressure hydrocephalus tend to get worse over the course of time if it is left untreated and progressive hydrocephalus can be fatal if it is not treated and managed effectively.

It is important for parents who have children with hydrocephalus to be aware that the condition affects physical and cognitive development. Individuals with hydrocephalus are treated by a multi-disciplinary team made up of medical professionals, as well as educational professionals and people focused on rehabilitation therapies.

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