Understanding Hydrocephalus

Hydrocephalus, often referred to as “water on the brain,” is a condition characterized by an abnormal buildup of cerebrospinal fluid (CSF) within the ventricles of the brain. This can lead to increased pressure on the brain tissues, causing a range of neurological symptoms. It can affect individuals of all ages, from infants to the elderly. Understanding the causes, symptoms, and treatment options for hydrocephalus is crucial for patients and their families.

Understanding Hydrocephalus

Causes of Hydrocephalus

Hydrocephalus can be classified into two main types: congenital and acquired. Each type has distinct causes:

Congenital Hydrocephalus

This form is present at birth and may result from genetic abnormalities or developmental disorders. Common causes include:

Spina bifida
Aqueductal stenosis (narrowing of the cerebral aqueduct)
Infections during pregnancy (e.g., rubella or cytomegalovirus)

Acquired Hydrocephalus

This type develops after birth and can occur at any age. Possible causes include:

Head injuries
Brain tumors
Infections like meningitis
Hemorrhages within the brain

Symptoms of Hydrocephalus

The symptoms of hydrocephalus can vary depending on the age of onset and the severity of the condition. Some common signs to look out for include:

Infants:

Rapid increase in head size
A bulging fontanel (soft spot on the top of the head)
Vomiting
Irritability
Poor feeding

Children and Adults:

Headaches
Nausea and vomiting
Blurred or double vision
Balance and coordination problems
Cognitive difficulties, such as memory loss or difficulty concentrating

Early diagnosis and treatment are essential to manage the symptoms effectively and prevent long-term damage.

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Treatment Options for Hydrocephalus

Treatment for hydrocephalus typically involves surgical intervention to drain the excess CSF and relieve pressure on the brain. The most common procedures are:

Ventriculoperitoneal (VP) Shunt:

A shunt system is placed to divert the flow of CSF from the ventricles to another part of the body, such as the abdominal cavity, where it can be absorbed.

Endoscopic Third Ventriculostomy (ETV):

An endoscopic procedure where a small hole is created in the floor of the third ventricle to allow CSF to bypass an obstruction and flow toward absorption sites around the brain’s surface.

Both procedures have their own risks and benefits, and the choice of treatment depends on individual patient factors, including the cause and severity of hydrocephalus, as well as the patient’s overall health.

Living with Hydrocephalus

With proper treatment, many individuals with hydrocephalus can lead full and active lives. Regular follow-up care is crucial to monitor the function of the shunt or the success of an ETV procedure. Patients should be aware of the potential complications, such as shunt malfunctions or infections, and seek medical attention if symptoms reoccur.

Key points for patients and families:

Maintain regular medical check-ups to monitor the condition.
Be vigilant for signs of shunt malfunction or infection.
Engage in physical and occupational therapy to address any motor or cognitive challenges.

Axial CT scan image showing extremely enlarged ventricles (the right and left lateral ventricles) as a result of hydrocephalus from a tumor obstructing the flow of Cerebrospinal Fluid (CSF).

A “normal” axial CT scan demonstrating normal and smaller ventricles, for comparison.

Coronal CT scan of the same patient, demonstrating the tumor obstructing the flow of CSF, resulting in ventricular enlargement of the bilateral lateral ventricles.

A “normal” coronal CT scan of the brain, demonstrating normal and smaller size of the ventricles, for comparison.

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