Hydrocephalus
Once known as “water on the brain,” hydrocephalus actually results from excessive accumulation of cerebrospinal fluid (CSF)—the clear fluid that surrounds the brain and spinal cord. This collection of CSF causes an abnormal dilation of the spaces in the brain, placing potentially harmful pressure on brain tissues. Hydrocephalus may be congenital or acquired.
As its name implies, congenital hydrocephalus is already present at birth and may be caused by genetic abnormalities or developmental disorders, such as spina bifida and encephalocele. Acquired hydrocephalus may develop at the time of birth or at some point afterward, and the condition can affect individuals of all ages. Various forms may result from stroke, traumatic injury, infection, tumor, or complications of surgery. However normal pressure hydrocephalus, most prevalent among the elderly, may be present without any obvious cause.
Symptoms of the condition will vary with age, disease progression, and the ways an individual tolerates CSF. The most obvious indication of hydrocephalus in infants is an unusually large head or the rapid increase in head circumstance. Symptoms in older children and adults may include headache followed by vomiting, nausea, swelling of the optic disc, downward deviation of the eyes, problems with balance and coordination, gait disturbance, urinary incontinence, developmental loss or delay, lethargy, drowsiness, irritability, or other changes in personality or cognition, including memory loss.
Hydrocephalus is diagnosed through clinical neurological evaluation and by using imaging techniques such as ultrasounds, computer tomography (CT), magnetic resonance imaging (MRI), or pressure-monitoring techniques.
Treatment
Hydrocephalus is most often treated with the surgical placement of a shunt system that diverts the flow of CSF to another area of the body where it can be absorbed as part of the circulatory process. An alternative procedure called third ventriculostomy may be used on a limited number of patients. This procedure involves creating a small hole in the floor of the third ventricle, which causes the CSF to bypass the obstruction and flow to where it can be absorbed around the surface of the brain.
Prognosis
There is some correlation between the cause of the condition and the patient’s ability to recover, but predicting outcome is complicated. Factors that influence prognosis include the presence of associated disorders, the timeliness of diagnosis, and the success of treatment. Untreated, the symptoms of normal pressure hydrocephalus usually get worse over time, although some people may experience temporary improvements. With rare exceptions, progressive hydrocephalus is fatal if left untreated. In children, hydrocephalus poses risks to both cognitive and physical development. Treatment by an interdisciplinary team of medical professionals, rehabilitation specialists, and educational experts is critical to a positive outcome, allowing many children to recover and lead normal lives with few limitations.
Disclaimer: The goal of this website is to provide information only. It is not a substitute for medical care and medical advice is not being offered. Consult your physician if you are experiencing health problems.
