Description

Hydrocephalus is the buildup of fluid in cavities called ventricles deep within the brain. The excess fluid increases the size of the ventricles and puts pressure on the brain.

The cerebrospinal fluid usually flows through the ventricles and bathes the brain and spine. But the pressure of too much cerebrospinal fluid can damage brain tissues and cause a variety of symptoms related to the function of the brain.

Hydrocephalus can occur at any age, but occurs most frequently among children and among adults older than 60 years. The surgery can restore and maintain the health of cerebrospinal fluid levels in the brain. The therapies can handle the resulting symptoms of hydrocephalus.

Symptoms

Symptoms of hydrocephalus vary with age.

Babies

The common symptoms of hydrocephalus in infants include:

The changes in the head

  • The head is larger than usual.
  • A rapid increase in the size of the head of a baby.
  • A bulging or tense the soft spot on the top of the head.

Physical symptoms

  • Nausea and vomiting.
  • Drowsiness or lethargy, known as the lethargy.
  • Irritability.
  • Good to eat.
  • Seizures.
  • With eyes fixed downward, known as the sunset on the eyes.
  • Problems with muscle tone and strength.

Small children and older children

Among young children and older children, symptoms may include:

Physical symptoms

  • The pain of a headache.
  • Blurred or double vision.
  • Movements of the eyes that are not usual.
  • The expansion of a child's head.
  • Drowsiness or lethargy.
  • Nausea or vomiting.
  • Problems with balance.
  • Poor coordination.
  • The lack of appetite.
  • The loss of control of the bladder or urinary frequency.

Behavioral and cognitive changes

  • Irritability.
  • Change in personality.
  • Decline in school performance.
  • Delays or problems with your previously acquired skills, such as walking or talking.

Young and middle-aged adults

The common symptoms in this age group are:

  • The pain of a headache.
  • Slowly.
  • Loss of coordination or balance.
  • The loss of control of the bladder or the need to urinate frequently.
  • Vision problems.
  • Decline in memory, concentration, and other thinking skills that can affect job performance.

Older adults

Among older adults of 60 years, the most common symptoms of hydrocephalus are:

  • The loss of control of the bladder or the need to urinate frequently.
  • The loss of memory.
  • The progressive loss of another line of thought or reasoning skills.
  • Difficulty walking, often described as dragging the feet or the feeling of the foot from being caught.
  • Poor coordination or balance.

When to see a doctor

Seek emergency medical attention for infants and young children with these symptoms:

  • A high-pitched cry.
  • Problems with the suction or power supply.
  • Recurrent vomiting with no clear cause.
  • Seizures.

Seek immediate medical attention for other hydrocephalus symptoms in any age group.

More than one condition can cause the problems associated with hydrocephalus. It is important to get a timely diagnosis and appropriate care.

Causes

Hydrocephalus is caused by an imbalance between the amount of cerebrospinal fluid is produced and how much is absorbed into the bloodstream.

Tissues that line the ventricles of the brain to produce the cerebrospinal fluid. Flows through the ventricles by means of channels. The liquid that eventually flows into the spaces around the brain and spinal cord. It is absorbed mainly through the blood vessels in the tissue at the surface of the brain.

The cerebrospinal fluid plays an important role in brain function by:

  • Allowing the relatively heavy brain to float inside the skull.
  • Cushioning in the brain to prevent injury.
  • The elimination of waste products of metabolism to the brain.
  • It flows back and forth between the brain cavity and the vertebral column. This flow is maintained constant, the pressure within the brain and allows for changes in blood pressure in the brain.

Too much cerebrospinal fluid in the ventricles may occur for one of the following reasons:

  • The obstruction. Partial obstruction of the flow of cerebrospinal fluid is the most common cause of excess cerebrospinal fluid in the ventricles. A blockage can occur from one ventricle to another, or from the ventricles to other spaces in the brain.
  • The poor absorption. Less common is a problem with the absorption of cerebrospinal fluid. This is often related to inflammation of the tissues of the brain of an illness or injury.
  • Overproduction. Rarely, the cerebrospinal fluid is created faster than it can be absorbed.

Risk factors

Most of the time, the cause of the hydrocephalus is not known. However, in the development or medical problems can contribute to or trigger the hydrocephalus.

Newborns

Hydrocephalus can be present at or before birth, known as congenital hydrocephalus. Or it can occur shortly after birth. Any of the following incidents can cause hydrocephalus in newborns:

  • The central nervous system developed in a way that blocks the flow of cerebrospinal fluid.
  • The bleeding occurred within the ventricles. This is a possible complication of premature birth.
  • The existence of an infection in the uterus during pregnancy, such as rubella or syphilis. An infection can cause swelling in the tissue of the brain of an unborn baby.

Other factors that contribute

Other factors that can contribute to hydrocephalus among any age group are:

  • Tumors of the brain or of the spinal cord.
  • Central nervous system infections, such as bacterial meningitis and mumps.
  • Bleeding in the brain from a stroke or head injury.
  • Other traumatic injury to the brain.

Complications

In most cases, the hydrocephalus is compounded. Without treatment, hydrocephalus leads to complications. Complications can include learning disabilities, or developmental and physical disabilities. The complications of this condition can also cause death. When the hydrocephalus is mild and treated, there may be few, if any, serious complications.

Diagnosis

A diagnosis of hydrocephalus is usually based on:

  • Their symptoms.
  • A general physical examination.
  • A neurological exam.
  • Brain-imaging tests.

Neurological examination

The type of neurological examination depends on the age of a person. A health professional could ask questions and conduct simple tests to judge the condition of muscle, movement, wellness, and function of the sensory capabilities.

Images of the brain

Imaging tests can help to diagnose hydrocephalus. You can also identify the underlying causes of the symptoms. The imaging tests are:

  • Ultrasound. This test is often the first test for children, as it is a simple, low-risk procedure. The ultrasound device is placed over the soft spot on the top of the baby's head. The ultrasound can also be found hydrocephalus before the birth, during the routine prenatal tests.
  • The magnetic resonance imaging.This test uses radio waves and a magnetic field to produce detailed images of the brain. This test is painless, but it is noisy and requires lying still. MRIscans can show enlargement of the ventricles caused by the excess of cerebrospinal fluid.MRIalso can be used to find the causes of hydrocephalus or other conditions contributing to the symptoms. Children may need medicine to help them feel calm, well-known as a mild sedation, to someMRIscans. However, some hospitals use a quick version ofMRIthat usually does not require sedation.
  • CTscan.This specialized X-ray technology that produces cross-sectional images of the brain. The scan is painless and fast. But this test also requires you to lie still, so that a child will usually receive a mild sedative. CTscans show less detail than doMRIscans. AndCTtechnology because of the exposure to a small amount of radiation.CTscans of hydrocephalus is usually used only for the emergency of the tests.

The magnetic resonance imaging. This test uses radio waves and a magnetic field to produce detailed images of the brain. This test is painless, but it is noisy and requires lying still.

The mri may show enlargement of the ventricles caused by the excess of cerebrospinal fluid. Magnetic resonance imaging can also be used to find the causes of hydrocephalus or other conditions contributing to the symptoms.

Children may need medicine to help them feel calm, known as mild sedation for some MRI scans. However, some hospitals use a quick version of the magnetic resonance that usually do not require sedation.

CTscan. This specialized X-ray technology that produces cross-sectional images of the brain. The scan is painless and fast. But this test also requires you to lie still, so that a child will usually receive a mild sedative.

The TC show less details that make the magnetic resonance imaging. And technology of the TC because of the exposure to a small amount of radiation. The TC for the hydrocephalus is usually used only for the emergency of the tests.

Treatment

One of the two surgical treatments can be used to treat hydrocephalus.

Derivation

The most common treatment for hydrocephalus is the surgical insertion of a drainage system, called a shunt. It consists of a long flexible tube with a valve that prevents the fluid in the brain flowing in the right direction at the right speed.

One end of the tubing is usually placed in one of the ventricles of the brain. The tube is then under the skin of other part of the body, as the stomach or a chamber of the heart. This allows the excess fluid is absorbed more easily.

People who have hydrocephalus usually need a referral system for the rest of their lives. They require regular monitoring.

Endoscopic third ventriculostomy

Some people may have a surgery called endoscopic third ventriculostomy. The surgeon uses a small video camera to see inside the brain. Then, the surgeon makes a hole in the bottom of a ventricle. This allows the cerebrospinal fluid to flow out of the brain.

Complications of the surgery

Both surgical procedures can result in complications. Shunt systems can stop draining cerebrospinal fluid. Or bypass systems may poorly regulate drainage because of mechanical problems, a blockage or infections. Complications of the ventriculostomy include bleeding and infection.

Complications of the surgery requires prompt attention. Another surgery, or other interventions may be needed. Fever or symptoms of hydrocephalus should ask an appointment with your health care professional.

Other treatments

Some people with hydrocephalus, in particular of children, you might need supportive therapies. Need of these treatments depends on the long-term complications of hydrocephalus.

The children in the care of the team may include:

  • The pediatrician or psychiatrist, who oversees the plan of treatment and care.
  • Pediatric neurologist, who specializes in the diagnosis and treatment of neurological disorders in children.
  • Occupational therapist, who specializes in therapy to develop life skills.
  • Developmental therapist, who specializes in therapy to help their child develop age-appropriate behaviors, social skills, and interpersonal skills.
  • Mental health professional, like a psychologist or a psychiatrist.
  • Social worker, who helps the family to obtain the necessary services and a plan for transitions in care.

The children in the school may need special education. Special education teachers address learning disabilities, determine the educational needs and help find the resources you need.

Adults with more severe complications may require the services of occupational therapists, and social workers. Or they may need to consult specialists in the care of patients with dementia or other medical specialists.

Coping and support

With the help of therapies and educational services, many people with hydrocephalus to live with few limitations.

If you have a child with hydrocephalus, there are many resources available to provide emotional and medical support. Children with disabilities may be eligible for government-sponsored health care and other support services. Check with your state or county social services agency.

The hospitals and the organizations that serve people with disabilities are a good resource for emotional and practical support. The members of your health care team can also help. Ask for help to connect with other families who are faced with hydrocephalus.

Adults living with hydrocephalus may find valuable information from organizations dedicated to hydrocephalus education and support, such as the Hydrocephalus Association.

You must be vaccinated against meningitis?

Ask your child's or your health care team if you or your child should receive a vaccine against meningitis, once a common cause of hydrocephalus. The Centers for Disease Control and Prevention recommends vaccination against meningitis books for children and boosters for adolescents. Vaccination is also recommended for young children and adults who might be at increased risk of meningitis due to any of the following reasons:

  • Travel to countries where meningitis is common.
  • To have a disease of the immune system called terminal complement deficiency.
  • Have a damaged spleen or after you have had the removal of the spleen.
  • Living in a dormitory of the school.
  • To join the armed forces.

Preparing for your appointment

The time of diagnosis of a child with hydrocephalus may depend on the severity of symptoms, and when the problems appeared. You can also depend on whether there are risk factors for hydrocephalus during pregnancy or childbirth. Sometimes, hydrocephalus may be diagnosed at birth or prior to birth.

Routine visits

It is important to take your child to all regularly scheduled routine visits. Health professionals monitor your child's development in key areas, including:

  • The size of the head, the rate of growth of the head and the general growth of the body.
  • The muscle strength and tone.
  • Coordination.
  • Posture.
  • Age-appropriate motor skills.
  • The sensory capabilities such as vision, hearing, and touch.

Questions that you should be prepared to answer during regular check-ups may include:

  • What are your concerns about your child's growth or development?
  • How well does your child eat?
  • How does your child respond to touch?
  • Is your child's achievement of certain development milestones, such as rolling over, pushing up, sitting up, crawling, walking or talking?

The preparation for other health care visits

It is likely to start by seeing your child's or your health care professional. Then, you may be referred to a doctor who specializes in the brain and nervous system conditions, known as a neurologist.

Be prepared to answer the following questions about your symptoms or your child's name:

  • What symptoms have you noticed? When do you start?
  • Have these symptoms changed over time?
  • Do these symptoms include nausea or vomiting?
  • Have you or your child has had any vision problems?
  • Have you or your child have a headache or fever?
  • Have you noticed personality changes, including increased irritability?
  • Has your child's school performance changed?
  • Have you noticed that new problems with movement or coordination?
  • Is your child having problems sleeping or lacking in energy?
  • Has your baby had a seizure?
  • Has your child had problems with eating or breathing?
  • In older children and adults, symptoms include the loss of bladder control and urinate more frequently?
  • Have you or your child has had a recent head injury?
  • Have you or your child has recently started a new medication?
Symptoms and treatment of Hydrocephalus