Hydrocephalus

Hydrocephalus is a condition where fluid builds up in the skull and causes the brain to swell. This condition is also called ‘water in brain’ and the build-up is often caused by an obstruction in the proper circulation of the brain fluid which lead to accumulation of the cerebrospinal fluid in brain. 

The condition requires treatment in order to prevent further complications. This mainly occurs in early childhood and adults above 60, researchers estimate that 1-2 out of every 1000 babies are born with Hydrocephalus.

What causes Hydrocephalus?

Cerebrospinal fluid (CSF) flows through your brain and spinal cord in normal conditions, the amount of CSF increases in your brain under certain conditions. This usually happens when:

  • Your brain produces an excess amount of it
  • A blockage develops that prevents CSF to flow normally
  • The ability the fluid  blood vessels is decreased

Too much of this fluid puts pressure on your brain which can damage your brain tissue and cause swelling. 

 Causes of Congenital Hydrocephalus 

  • A genetic abnormality
  • A birth defect in which spinal column does not close
  • Infections that occur during pregnancy like Rubella
  • Injuries that might occur before, during or after delivery
  • Central nervous system tumours
  • Head Trauma
  • Bleeding in brain during or shortly after delivery

Causes of Acquired Hydrocephalus 

This condition is usually due to injury or illness.

  • Brain Tumours
  • Brain Haemorrhage – Bleeding inside the brain
  • Brain Lesions – Areas of injury or disease within the brain
  • Meningitis – Inflammation of membranes of brain or spinal cord

What are the potential Signs and Symptoms of Hydrocephalus?

Present at Birth:

  • Breathing Difficulties
  • Irritability or drowsiness or both
  • Development stages may be delayed such as crawling or sitting up
  • Arm and leg muscles may be stiff and prone to contractions 
  • Poor feeding
  • Head seems larger than it should be 
  • Scalp is thin and veins are visible on scalp
  • Unwillingness to move or bend the neck
  • High pitched cry
  • Possible vomiting 
  • Pupils of the eyes may be close to the bottom of the eyelid

Symptoms of Acquired Hydrocephalus

  • Confusion, disorientation or both
  • Drowsiness or lethargy
  • Irritability
  • Lack of Appetite, Nausea
  • Problems with eyesight 
  • Walking difficulties, especially in adults
  • Personality changes
  • Urinary incontinence
  • Chronic Headaches
  • Difficulty in concentration 

Diagnosis and investigations of Hydrocephalus 

These symptoms could not be ignored and picked up in early stage by your clinician and surgeon. There are certain signs which are obvious of hydrocephalus. Complete neurological examination is done to evaluate the disease and possible causes. However to confirm and diagnose in early stages  routine ultrasound scan will be used to detect congenital hydrocephalus in the foetus.

After birth the head of the baby is measured and abnormalities in size may lead to further diagnostic tests. 

If the ultrasound shows any abnormality then further test such as Magnetic resonance imaging (MRI) of the brain and spine and Contrast enhanced computerised tomography (CT scan) of the head are done. These investigations will help in providing the necessary information about the leaves of obstruction in brain or spine and planning further intervention to treat the patients. 

What is the treatment for Hydrocephalus?

Hydrocephalus can be fatal if left untreated. Treatment cannot reverse the damage which is already caused however we can prevent further damage. The aim of the treatment lies in drainage of the spinal fluid relieving obstruction and enhancing normal circulation. The most of acquired  cause of the hydrocephalus are directed towards treating the primary cause to relieve obstruction and the following bridge measures can be taken to provide immediate relief. Following surgical options may be suggested.

Shunt Insertion

A shunt is surgically inserted. It is a drainage system made of a long tube with valve. The valve helps CSF flow in normal rate in the right direction. One end of the tube is inserted in your brain and the other end into your chest or abdominal cavity. The excess fluid drains from the brain to the other end of the tube where it is more easily absorbed. This implant is usually permanent and has to be monitored.

Ventriculostomy

It is an alternative procedure to shunt insertion. This involves making a hole at the bottom or in between the ventricles. This allows the CSF to leave the brain.

Make sure you get prenatal care during pregnancy in order to avoid this condition. Get vaccination to prevent illness and infection that are linked to hydrocephalus. Use safety equipment such as helmet to prevent head injury. Young children should always be secured in a car seat.

To consult with our  best team of Neuro and Spine surgeons at Surgeons House Limited (SHL) available at different global locations. Please click this link to contact us.

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