Hydrocephalus is a medical condition in which excess cerebrospinal fluid (CSF) builds up within the ventricles of the brain, leading to increased pressure in the head. It’s a condition that more commonly affects newborns and infants, but it can also develop during childhood or in adults. Medical data suggest that it affects about one in every 500 children, and today, we are taking a closer look at what causes hydrocephalus, the symptoms that come with it, and how the condition is best treated.
The Causes and Symptoms of Hydrocephalus
There are a number of different reasons that can lead to excess CSF fluid in the brain. In some individuals, it can be inherited genetically or may be associated with certain developmental disorders, like spina bifida or encephalocele. Other causes include bleeding in the brain, a brain tumor that disrupts normal CSF flow, head injuries, infections or complications from a premature birth (like a hemorrhage). Any condition that disrupts the normal flow of cerebrospinal fluid from the brain can lead to symptom onset. Symptoms vary based on the age of the individual battling the condition, but the most common symptoms by age include:
Symptoms in Infants – Abnormal head enlargement, bulging soft spot on hear, appearance of a thin scalp, bone separation on the baby’s head, prominent scalp veins, drowsiness, vomiting, seizures, poor appetite and a downward deviation of the baby’s eyes.
Symptoms in Toddlers or Children – Abnormal head enlargement, headaches, vomiting, nausea, blurred vision, balance issues, tiredness, poor coordination, delayed walking, personality changes, difficulty concentrating, irritability, difficulty falling asleep or staying asleep, seizures and poor appetite.
Symptoms in Adults – Balance and coordination issues, headaches, memory loss, bladder problems, gait changes, nausea, vomiting and confusion. Oftentimes this gets misdiagnosed as Alzheimer’s disease or dementia in adults over the age of 60.
Diagnosing and Treating Hydrocephalus
A diagnosis can be made by a neurosurgeon or another head and brain specialist. During the examination, your specialist will look for physical symptoms listed above, review your medical history and if possible, ask the patient about their symptoms. From there, the doctor may order an ultrasound, CT scan or MRI to reveal the severity of the pressure and chart a course for treatment.
If pressure is revealed and it’s unlikely that the CSF will drain properly without intervention, your surgeon will walk you through some surgical options. Hyrdrocephalus can be treated either directly or indirectly.
Direct treatment – Direct treatment involves removing the CSF obstruction, whether this is a cyst, tumor or another blockage that can be safely removed. This is the preferred method if the blockage can be safely removed.
Indirect treatment – Indirect treatment means that the neurosurgeon will help fix the problem, but the root cause of blockage may not be addressed. Indirect treatment often involves the insertion of a shunt, which is a device that diverts excess CSF away from the brain. If the blockage cannot be removed, a shunt can help to keep CSF fluid from building in the brain in order to alleviate symptoms.
In some cases, both an indirect and direct procedure are performed. The indirect procedure involves inserting the shunt to drain the CSF and reduce pressure, and then once at a safe level, the blockage is removed with a direct procedure.
After surgery, you will have your neurological functions tested to see if any issues still persist, but for the majority of patients, draining the CSF alleviates symptoms, so long as it was treated within a reasonable amount of time. If a shunt is inserted, expect follow up imaging tests to ensure everything is draining as it should. If you begin experiencing headaches, vision issues or a recurrence of symptoms in the future, head back into the doctor’s office, because you may need to have the shunt adjusted. Caught early enough, treatment of hydrocephalus has a very positive outlook.
For more information, reach out to Dr. Chang’s office today.