Hydrocephalus is a significant accumulation of cerebrospinal fluid in the brain cavity or the ventricles. This extra fluid causes the ventricles to expand and puts harmful pressure on the brain tissue. Do you know why hydrocephalus occurs and what are its treatment methods? To learn more about this disease, stay with us until the end of the article.
What is hydrocephalus?
Hydrocephalus disease is derived from the Greek words “hydro,” meaning “water,” and “safari,” meaning “head.” This disease is an abnormal accumulation of fluid in the brain, which is also called intracerebral fluid. This water is cerebrospinal fluid (CSF). Cerebrospinal fluid is a clear, colorless fluid that surrounds the brain and spinal cord. Usually, this vital fluid flows throughout the brain and ventricles, delivering nutrients to the brain and removing waste products. Also, in addition to cleaning the brain and spinal cord, it protects them from damage.
Usually, the body makes the necessary cerebrospinal fluid daily and absorbs a similar amount. However, when the average flow or absorption of cerebrospinal fluid is disturbed, it causes an accumulation of cerebrospinal fluid. With the expansion of the cerebrospinal fluid, the ventricle is enlarged. Therefore, the pressure inside the head increases, and it is possible to disturb the brain’s functioning.
Types of hydrocephalus
1. Communicative hydrocephalus
In this type of hydrocephalus, the flow of cerebrospinal fluid is blocked after leaving the ventricle. This type of hydrocephalus can cause the thickening of the basement membrane of the brain called the arachnoid and prevent the free flow of cerebrospinal fluid. However, cerebrospinal fluid can still flow between open ventricles, which is why it is called communicating hydrocephalus.
2. Noncommunicating hydrocephalus
Noncommunicating hydrocephalus, or obstructive hydrocephalus, occurs when the flow of cerebrospinal fluid is blocked in one or more of the narrow passages that connect your ventricles.
3. Normal pressure hydrocephalus (NPH)
It occurs when the accumulation of cerebrospinal fluid causes the ventricles to enlarge, but it is small enough that it does not increase the pressure. The difference between hydrocephalus with normal pressure and other types of this disease is that although cerebrospinal fluid is higher than usual, the pressure inside the brain is similar to normal. The accumulation of cerebrospinal fluid occurs slowly, and symptoms develop over time. This disease usually occurs in old age.
4. ex-vacuo hydrocephalus
This disease is caused by brain damage caused by head injury or stroke. In this condition, the brain tissue around the ventricles shrinks, so cerebrospinal fluid accumulates in the ventricles to fill the extra space. The ventricles are enlarged, but intracranial pressure usually remains normal.
5. Ventricular legally hydrocephalus
Another type of hydrocephalus is ventriculomegaly. This term is used when the ventricles of the fetal brain are large. Although this disease can cause ventricular honestly, it may have other causes.
Cause of hydrocephalus
1. Congenital factors
A combination of genetic and environmental factors during fetal development may cause congenital hydrocephalus. Congenital means a disease at the time of birth.
The most common causes of fetal hydrocephalus are:
- Spina bifida and other defects of the brain and spinal cord (neural tube);
- narrowing of the path between the third and fourth ventricles of the brain;
- Complications of premature birth, including bleeding between the ventricles;
- An infection such as rubella during pregnancy can cause inflammation in the brain tissue of the fetus.
2. Acquisition factors
This disease may occur at any time after birth and any age. The most common causes of acquired hydrocephalus are:
- head injury;
- stroke ;
- brain or spinal cord tumors;
- Meningitis or other infections of the brain or spinal cord.
Hemorrhage or side effects of surgery may cause normal pressure hydrocephalus. Of course, many people get this disease without a clear cause.
Symptoms of hydrocephalus
The symptoms of this disease vary according to age. It may also change with disease progression or increased cerebrospinal fluid accumulation.
1. Symptoms of hydrocephalus in infants
- unusual head size;
- the rapid increase in head circumference;
- severe restlessness;
- excessive sleepiness;
- poor nutrition;
- low muscle volume and low muscle strength;
- a raised soft spot on the top of the baby’s head;
- Looking down the child’s eyes;
- nausea _
2. Symptoms of hydrocephalus in children
- headache ;
- nausea and vomiting;
- short, loud cries;
- personality changes;
- eye deviation;
- muscle cramp;
- change in facial structure;
- eating problems;
- extra sleep;
- restlessness;
- loss of coordination;
- loss of bladder control;
- difficulty concentrating;
- vision problems;
- Growth delay.
3. Disease symptoms in adults
- Headache;
- memory weakness;
- nausea and vomiting;
- vision problems;
- feeling tired ;
- balance and coordination problems;
- Short-term memory loss.
4. Symptoms of the disease in the elderly
- walking problems;
- mild dementia ;
- forgetfulness ;
- Loss of bladder control.
Diagnosis of hydrocephalus
This disease is diagnosed with neurological evaluations. The doctor may use imaging methods such as ultrasound, computed tomography (CT), or MRI for a better diagnosis. Other tests may also be prescribed to diagnose the disease in adults, including:
- Spinal tap (lumbar puncture).
- Intracranial pressure (ICP) check: A small device is inserted into the brain and measured.
- Fundoscopy test: they use a particular device to observe the optic nerve behind the eye.
Treatment of hydrocephalus
Currently, the only way to treat hydrocephalus is brain surgery. 2 types of brain surgery are used to treat this disease:
- Shunt: The most common type of hydrocephalus treatment is placing a device called a shunt in the brain. A shunt is a flexible tube placed in the brain and transfers cerebrospinal fluid to other body areas that can absorb the liquid.
- Endoscopic ventriculostomy of the third ventricle ( ETV ): In this surgery, a small hole is created in the floor of the third ventricle, and a path is formed for the normal flow of cerebrospinal fluid into and around the brain. This surgery is usually performed in children over two years old.
Side effects of treatment
Many have had no side effects for years, but things can change quickly. People with shunts may need regular medical check-ups. The shunt may break, become ineffective, or become infected. In this situation, another surgery is required. Endoscopic ventriculostomy of the third ventricle can also be closed at any time, putting the person at risk.
If you have symptoms of shunt insufficiency or third ventricular endoscopic ventriculostomy closure, you should see your doctor. These symptoms are similar to those of hydrocephalus, including:
- Headache;
- vision problems;
- nausea and vomiting;
- feeling exhausted.
New symptoms may also appear, such as:
- neck or shoulder muscle pain;
- convulsions ;
- redness or tenderness of the area around the shunt;
- mild fever
Life of hydrocephalus patients
Many people suffer from brain damage after contracting this disease. This depends on the progression of the disease, the duration of symptoms before receiving treatment, and side effects such as infection. Also, adults with severe symptoms may need an occupational therapist or may need to see a dementia specialist.
Common questions
– What people get this disease?
2 out of every 1000 children are born with hydrocephalus. Of course, this disease also occurs in older children and adults.
– Does hydrocephalus cause death?
If this disease is not treated, it can lead to death. But know that although hydrocephalus cannot be prevented, it can be treated with surgery.
– Does this disease go away by itself?
No Untreated hydrocephalus can be fatal. Early diagnosis and successful treatment improve the chances of recovery.
Can hydrocephalus be prevented?
No, but you can reduce your or your child’s chance of getting this disease by doing some things, including:
- prenatal care;
- vaccination;
- Use of safety devices in situations such as cycling;
- Buying safe equipment such as baby seats for children.
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Warning! This article is only for educational purposes; to use it, it is necessary to consult a doctor or specialist.
