What is Hydrocephalus? An Overview

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Hydrocephalus is a chronic, neurological condition caused by an abnormal accumulation of cerebrospinal fluid (CSF), resulting in pressure on the brain. It affects over 1 million Americans, ranging from infants and older children, to young, middle-aged adults, and seniors. While there is currently no cure for hydrocephalus, it can be treated.

What causes Hydrocephalus?

Hydrocephalus can develop for a variety of reasons, sometimes as part of another condition. You can be born with it, acquire it from certain brain diseases, or develop it as part of the aging process.

Congenital hydrocephalus, the form of hydrocephalus that is present at birth, is most commonly caused by:

  • Spina bifida
  • Aqueductal stenosis
  • Brain malformations

Acquired hydrocephalus, the form of hydrocephalus that develops after birth, is most commonly caused by:

  • Head injuries
  • Brain tumors
  • Intraventricular hemorrhage, commonly as a complication of prematurity
  • Meningitis or other infection of the brain or spinal cord

Normal pressure hydrocephalus (NPH) occurs in older adults. It is an accumulation of CSF that causes the ventricles in the brain to become enlarged, sometimes with little or no increase in intracranial pressure (ICP). In most cases of NPH, the cause of NPH is unclear.

For more detailed information, visit Classifications and Causes.

What are the symptoms of Hydrocephalus?

The symptoms of untreated hydrocephalus vary.  However, here are some overarching signs and symptoms of the condition:

  • In-utero, for pregnant woman, an ultrasound may detect enlarged ventricles, indicating the possible presence of hydrocephalus.
  • In an infant, the most obvious sign of hydrocephalus is an abnormal enlargement of the baby’s head. Additional symptoms include vomiting, sleepiness, bulging soft spot and downward deviation of the baby’s eyes (the sun setting eyes)
  • In children raised intracranial pressure (ICP) may cause symptoms that include nausea, vomiting, headaches and vision problems.
  • In young and middle-aged adults symptoms due to hydrocephalus include, but are not limited to, disturbance in gait, thinking processes, and bladder control. Chronic headaches are also frequently reported.
  • In older adults with NPH, the most common symptoms are gait disturbances (walking and standing), cognitive abilities (mild dementia, forgetfulness, or loss of interest) and impairment in bladder control.

For more detailed information, visit Symptoms and Diagnosis.

Is it treatable?

Yes.

With early detection and appropriate intervention, the future for many is promising. There are three forms of surgical treatment currently used to manage hydrocephalus.

  1. The most common treatment is a medical device called a shunt, a flexible tube, which is placed in the ventricular system of the brain. A shunt diverts the flow of CSF to another region of the body, most often the abdominal cavity, or heart, where it can be absorbed.
  2. A second alternative surgical treatment option is called an endoscopic third ventriculostomy (ETV). With this procedure an endoscope is used to puncture a membrane on the floor of the third ventricle. This creates a pathway for CSF flow within the cavities in the brain and a shunt is not needed. Not everyone is a candidate for the ETV treatment.
  3. The third treatment option involves the addition of choroid plexus cauterization (CPC) with ETV. The neurosurgeon uses a device to burn or cauterize choroid plexus tissue. The choroid plexus is a network of blood vessels in the ventricles of the brain where CSF is produced. Not everyone is a candidate for the ETV/CPC treatment.

Advances in technology as well as diagnostic and treatment protocols are helping more and more people with hydrocephalus to lead full and active lives.  However, the ultimate goal is a cure.

For more detailed information, visit Treatment Options.

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