Hydrocephalus

Hydrocephalus is the abnormal accumulation of fluid in your brain. Hydrocephalus is derived from the Greek words "hydro," meaning water, and "cephalus," meaning head. Hydrocephalus was once known as "water on the brain." The "water" is cerebrospinal fluid (CSF), a clear, colorless fluid that surrounds the brain and spinal cord. Normally, CSF travels through ventricles in the brain. CSF acts as a nutrient delivery and waste elimination mechanism for the brain. CSF bathes your brain and spinal cord, protecting and cushioning them against injury. CSF is then reabsorbed into the bloodstream.

Your body typically creates the CSF it requires each day and then reabsorbs the same amount. However, when the normal flow or absorption of CSF is impeded, CSF can accumulate. As CSF accumulates, the ventricles widen. This generates increased pressure inside your head. Too high CSF pressure can interfere with your brain's normal operation.

Different types of hydrocephalus

There are four primary varieties of hydrocephalus: communicative hydrocephalus, non-communicating hydrocephalus, normal pressure hydrocephalus, and hydrocephalus ex-vacuo.

• Communicating hydrocephalus occurs when the flow of CSF is obstructed after it exits your ventricles. This type of hydrocephalus can be caused by arachnoid membrane thickening at the base of the brain. This barrier hinders the free passage of CSF. This type of hydrocephalus is known as communicating because CSF can still flow between your ventricles, which remain open.
• Non-communicating hydrocephalus is often referred to as obstructive hydrocephalus. Non-communicating hydrocephalus develops when the flow of CSF is obstructed along one or more of the tiny tubes that connect your ventricles.
• Normal pressure hydrocephalus (NPH) occurs when CSF buildup causes your ventricles to expand with little to no increase in pressure. The distinction between NPH and other types of hydrocephalus is that, despite the presence of more CSF than normal, the pressure inside your ventricles remains constant. The accumulation of CSF in your ventricles occurs gradually, and symptoms appear over time. NPH occurs most frequently among the elderly.
• Hydrocephalus ex-vacuo is caused by brain damage following a head injury or stroke. In some circumstances, the brain tissue surrounding the ventricles shrinks. CSF accumulates in your ventricles to fill the additional space. Although your ventricles are enlarged, the pressure in your head is generally normal.

Symptoms

Infants' symptoms may include:

• Unusually large head.
• A swollen soft spot (fontanel) on top of your baby's head.
• Your baby's eyes are turned downward (sunsetting eyes).
• Vomiting.
• Sleepiness.

Symptoms in older children can include:

• Headache.
• Nausea and vomiting.
• Vision problems.
• Developmental delays.

Adults' symptoms may include:

• Headache.
• Nausea and vomiting.
• Vision problems.
• Feeling tired.
• Problems with balance and coordination.
• Short-term memory loss.

Symptoms in older adults can include:

• Problems walking (gait disturbances).
• Mild dementia.
• Forgetfulness
• Loss of bladder control.

Causes

The most common causes of congenital hydrocephalus include:

• Spina bifida and other brain and spinal cord (neural tube) abnormalities.
• Aqueductal stenosis is a narrowing of the small passage between the brain's third and fourth ventricles.
• Premature birth complications, such as bleeding in the ventricles.
• Infections during pregnancy, such as rubella, can cause inflammation in the fetal brain.

The most common causes of acquired hydrocephalus include:

• Head trauma.
• Stroke.
• Brain or spinal cord tumors.
• Meningitis or other infections of your brain or spinal cord.

Diagnosis

A neurological assessment is used to diagnose hydrocephalus. Your doctor may utilize brain imaging techniques, including ultrasounds, computer tomography (CT), or magnetic resonance imaging (MRI). Other tests are frequently used in adults to diagnose the illness. These tests can include:

• Spinal tap (lumbar puncture).
• Intracranial pressure monitoring (ICP) involves inserting a small pressure monitor into your brain to measure pressure.
• A fundoscopic examination uses a specialized device to view the optic nerve in the back of your eye.

Treatment

Yes. Hydrocephalus is treatable. While there is presently no way to prevent or cure hydrocephalus, it can be treated surgically. Currently, the only option to treat hydrocephalus is through brain surgery. Hydrocephalus is treated using two types of brain surgeries:

• Shunt. The most frequent therapy for hydrocephalus is surgical installation of a medical device known as a shunt. A shunt is a flexible tube that is implanted inside your brain. It transfers the surplus CSF to another part of your body, where it can be absorbed.
• Endoscopic third ventriculostomy (ETV): This operation involves creating a tiny hole in the floor of your third ventricle. This opens up a conduit for CSF to circulate in and around your brain as it would ordinarily. This surgery is often performed on children over the age of two.

Conclusion

Hydrocephalus is a difficult disorder that requires prompt diagnosis and treatment to avoid complications and improve quality of life. Advances in medical therapies, surgical interventions, and ongoing research offer promise for improved results for patients suffering from hydrocephalus. If you suspect you or a loved one has hydrocephalus, seek medical help right away to discuss the best treatment options available. For information, visit SHALBY Sanar International Hospitals in Gurugram.