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Hydrocephalus – Symptoms, Causes, Treatment, Pictures

Hydrocephalus is a condition characterized by accumulation of fluid deep inside the brain within the ventricles or cavities. The increased fluid leads to enlargement of the ventricles and exerts additional pressure on the brain

Cerebrospinal fluid covers the spinal column and the brain and generally travels via the ventricles. But the excess presence of cerebrospinal fluid in the ventricles in hydrocephalus patients can destroy the brain tissues and also result in various deficiencies in brain functionality. The condition commonly occurs in older adults and infants, but can also affect people of any age group.

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Hydrocephalus can be treated via surgical means which restores the levels of cerebrospinal fluid and maintains the balance. The functional deficiencies and other symptoms that result from hydrocephalus have to be managed with different types of therapies and interventions.

Hydrocephalus Symptoms

The signs and symptoms of hydrocephalus as per the age groups are listed below:

  • Infants:
    • An abnormally big head
    • Irritability
    • The fontanel or soft spot present on top of the head is tense or bulging
    • The size of the head may rapidly increase
    • Poor feeding
    • The muscle tone, receptiveness to touch, strength and expected development is deficient and impaired
    • Vomiting
    • The eyes are set downwards
    • Seizures
    • Sleepiness
    • Older children and toddlers:
      • The toddlers head may be unusually enlarged
      • Vomiting or nausea
      • Headache
      • Fever
      • Previously learnt skills like talking and walking may become problematic
      • Talking and walking may be delayed
      • Double vision or blurred vision
      • Poor coordination
      • Balance is unsteady
      • Irritability
      • Attention difficulties
      • Personality changes
      • Problems in waking up or staying awake
      • School performance may decline
      • Seizures
      • Poor appetite
      • Sleepiness
      • Young and middle-aged people:
        • Vision deficits
        • Headache
        • Loss of balance or coordination
        • Problems in waking up or staying awake
        • Loss of bladder regulation or a persistent desire to urinate
        • Concentration, memory and other cognitive skills may experience a decline thereby affecting performance at work
        • Older adults (60 years and above):
          • Bladder control may be lost or there may be a frequent desire to urinate
          • Cognitive, reasoning and thinking capability may progressively deteriorate
          • Loss of memory
          • Problematic walking, which can be visible as trying to walk but the foot is stuck, or a shuffling gait
          • The overall movements become slower than usual
          • Poor balance or coordination

Causes of hydrocephalus

Hydrocephalus is caused due to a disturbance in the balance between the quantity of cerebrospinal fluid that is manufactured and the amount of fluid that is taken up into the bloodstream

The lining of ventricles in the brain contains tissues that produce the cerebrospinal fluid. It travels with the brain via the ventricles that are can be seen as interconnecting channels and ultimately passes into the spaces around the spinal column and the brain. The blood vessels present in the tissues adjacent to the lower end of the brain, absorb this fluid. Cerebrospinal spinal fluid is important because it performs the following vital functions:

  • It allows the heavy brain to remain buoyant and float inside the skull
  • It facilitates the removal of wastes produced by the metabolism of the brain
  • It prevents brain injury by acting as a cushion
  • It aids the maintenance of a steady pressure inside the brain by constantly travelling in the cavities around the spinal column and brain, and also compensates for blood pressure changes that occur in the brain

Cerebrospinal fluid may be present in excessive amounts, leading to hydrocephalus, due to the following possible reasons:

  • It may be caused due to presence of any blockage in the normal pathways of the fluid, such as an obstruction that prevents flow from one ventricle to another, or a blockage that prevents fluid flow from the ventricles to other spaces in the brain
  • In rare cases, the process of fluid creation may be faulty, leading to fluid overproduction that cannot be as rapidly absorbed
  • On rare occasions, presence of a brain disease or injury can affect the functioning of the vessels that absorb the cerebrospinal fluid, causing decreased absorption and thus excessive fluids.

The exact causes of the onset of hydrocephalus are unknown. But some of the possible triggers that may result in hydrocephalus include the following:

  • Newborns suffering from bleeding ventricles, or an abnormally developed central nervous system, or inflammation of brain tissues due to infection of fetus during pregnancy are at greater risk to develop hydrocephalus
  • Children and adults who have tumors or lesions in the brain; have suffered a brain trauma, injury or stroke or have been infected by meningitis or other brain diseases can develop hydrocephalus

Treatment of hydrocephalus

Hydrocephalus is treated via two types of surgical methods, which are discussed below:

  • Shunting is a procedure wherein a flexible tube containing a valve is inserted inside one of the affected ventricles to drain the excess fluid. The other end of the tube is generally directed to other body parts like a cardiac chamber or the abdomen where it is easily absorbed
  • Ventriculostomy is a surgical method that involves making a hole between affected ventricles or at the bottom of the ventricle to allow the fluid to flow out.

Both the surgical procedures can result in some complications. Hydrocephalus, especially in children, is accompanied by various brain function deficits and other symptoms which have to be managed accordingly as per the advice of a battery of specialist doctors.

Hydrocephalus Pictures


 

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