Information about Hydrocephalus

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What is hydrocephalus?

Hydrocephalus comes from the Greek word “hydro,” meaning water, and “cephalus,” meaning head. It is a neurological condition that exists when excess cerebrospinal fluid (CSF) builds up in cavities, called ventricles, inside the brain.

Fluid accumulates in the ventricles when the body produces more CSF in a day than it can reabsorb. This accumulation causes enlargement of the ventricles, resulting in hydrocephalus.

Hydrocephalus is usually treated by surgically implanting a shunt that takes excess CSF from the brain to another part of the body.

Here is a short video explaining Hydrocephalus:


 

Who can have hydrocephalus?

Babies: Hydrocephalus may develop in the womb or after birth as a result of a congenital defect. This defect is not necessarily hereditary, but may result from something (including the condition known as spina bifida) that goes wrong during development of the fetus. Hydrocephalus may also result from complications associated with premature birth.

Children, young and middle-aged adults: Hydrocephalus may develop during these years as a result of intracranial bleeding, (stroke), brain injury, tumour growth, meningitis or other factors. Hydrocephalus that occurs after birth as a result of one of these factors is called “acquired hydrocephalus.”

Seniors: When it is diagnosed during these years, hydrocephalus is typically called “adult onset hydrocephalus.” It may take one of two forms: the common form of hydrocephalus which involves high intracranial pressure or normal pressure hydrocephalus (NPH).

 

What causes hydrocephalus?

Hydrocephalus can be caused by a variety of medical problems. It can be present at birth, as a result of a congenital condition. For example, hydrocephalus may occur along with spina bifida, aqueductal obstruction, arachnoid cysts or Dandy-Walker Syndrome. Acquired hydrocephalus may occur at any time during a person's life as a result of intraventricular hemorrhage, meningitis, head injury, tumours, or an unknown cause. Approximately, eighty percent of individuals with spina bifida also have hydrocephalus.
 

What are the symptoms of hydrocephalus?

Hydrocephalus can be a serious condition, and must be treated. When it is not treated it can cause permanent brain damage or in severe cases, death. Here are the signs to watch out for:

Infants:

  • head enlargement
  • fontanel (soft spot) is bulging when baby is upright and quiet
  • prominent scalp veins appear unnaturally full
  • fever (infection)
  • vomiting (especially projectile)
  • sleepiness
  • irritability
  • seizures
  • downward deviation of the eyes (sunset eyes)

Toddlers:

  • head enlargement caused by enlarged ventricles
  • headache
  • vomiting (especially projectile)
  • irritability and tiredness
  • visual disturbances: blurred or double vision
  • loss of previous cognitive or motor abilities, delayed development in walking and talking, or poor coordination or balance
  • seizures
  • lethargy/listlessness/sleepiness
  • bowel and bladder incontinence
  • change in personality, unable to concentrate

Older Children:

  • fever,
  • headache
  • vomiting (especially projectile)
  • visual disturbances: blurred or double vision
  • personality change
  • loss of coordination or balance
  • seizures
  • tiredness or difficulty staying awake
  • difficulty waking up from sleep
  • irritability
  • incontinence
  • impairment of mental or motor performance
  • decline in academic or work performance

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Young & Middle-aged Adults:

  • incontinence
  • headache unrelieved by pain medication
  • visual disturbances, fainting
  • gait disturbances: clumsiness, difficulty walking on uneven surfaces and stairs
  • cognitive problems: dependent on lists, decline in academic or work performance

* The headaches experienced by toddlers, children and adults are often at the front of the head on both sides. They are generally severe upon waking in the morning or following a nap, and may be relieved by sitting up.

If you are experiencing any symptoms related to hydrocephalus, seek immediate medical attention as the condition can become life-threatening.
 

What are the problems associated with hydrocephalus?

Problems associated with hydrocephalus differ from person to person. A child with congenital hydrocephalus may experience difficulty walking or with eye-hand coordination whereas an elderly person with hydrocephalus may experience incontinence. The problems depend on the underlying cause of the hydrocephalus, extent of brain damage, associated complications, and treatment. Learning disabilities are among the most commom complications for people with hydrocephalus. Individuals are able to learn. However, they may require modifications to the way they are taught, especially when it comes to learning new things whether they be academic or on the job skills. Over the years, medical professionals have recognized that some children and adults with hydrocephalus may experience difficulty in one or more of these areas: learning disabilities; memory loss; motor skills; pressure sensistivity; visual impairment; seizures; constipation; incontinence; hormonal imbalance.
 

Will hydrocephalus cause brain damage?

If untreated, hydrocephalus can cause serious brain damage. Even when treated, it may still cause some injury to the brain. Some cases are more severe than others. The extent of brain damage may also depend on the cause of the hydrocephalus. Someone who has a head injury as a result of a car accident, for example, may have extensive damage to the brain as a result of the injury, not the hydrocephalus.
 

How is hydrocephalus treated?

Treatment for hydrocephalus usually involves surgically implanting a flexible tube (a shunt) into the brain ventricles to drain away excess cerebrospinal fluid. With treatment, mental capability and lifespan are similar to those of the general population. However, most people with spina bifida and/or hydrocephalus will have some form of learning disability.

An increasingly common alternative to the insertion of a shunt is a surgical procedure called Endoscopic Third Ventriculostomy (ETV). A small hole is made in the thinned floor of the third ventricle, allowing cerebrospinal fluid (CSF) to flow out of the blocked ventricular system and into the interpenducular cistern (a normal CSF space).

Here is video of an actual ETV surgery being performed:

 

Can hydrocephalus be cured?

There is no cure for hydrocephalus. In most cases, it is a condition that is present for life, except when it is the result of a brain tumour. In this case, it may be possible to remove the tumour, and allow the cerebrospinal fluid to flow.

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