Hydrocephalus Treatment is a surgical procedure that is performed to drain out excess fluid from the skull, which can cause the brain to swell. Brain damage happens as a result of the fluid buildup in the skull that can lead to the developmental, physical and intellectual impairments. Hydrocephalus mainly occurs in children and adults over the age of 60.
What causes Hydrocephalus:
What Causes Hydrocephalus?
Cerebrospinal fluid (CSF) flows through the brain and spinal cord in normal conditions. Under certain conditions, the amount of CSF in the brain increases that leads to Hydrocephalus. The amount of CSF can increase when:
- Blockage develops that prevents CSF from flowing normally
- There is a decrease in the ability of blood vessels to absorb it
- The brain produces an excess amount of it
As per the patient’s condition, doctor may recommend one of the two procedure, which are as follows
- Shunt Insertion – The shunt is a drainage system made of a long tube with a valve that helps CSF flow at a normal rate and in the right direction
- Ventriculostomy – This procedure is performed as an alternative of shunt insertion. This involves making a hole at the bottom of a ventricle or in between ventricles for draining out the CSF
Hydrocephalus is a condition that occurs when fluid builds up in the skull and causes the brain to swell. The name means “water on the brain.” Also called Cerebro-spinal fluid it is a clear fluid absorbed by the brain. This CSF circulates from the brain cavity system and thereafter from the subarachnoid space surrounding the spinal cord and brain
Brain damage can occur as a result of the fluid buildup. This can lead to developmental, physical, and intellectual impairments. It requires treatment to prevent serious complications.
Hydrocephalus mainly occurs in children and adults over 60, but younger adults can get it too
Types of Hydrocephalus
Types of hydrocephalus include:
Congenital hydrocephalus, which is present at birth. Congenital hydrocephalus may be caused by physical problems with how CSF flows or is made or absorbed, by infections or trauma during fetal development, or by teratogens. It may be linked with other birth defects that affect the spine, especially open neural tube defects.
Acquired hydrocephalus, which develops at the time of birth or later. It can be caused by infections such as meningitis, bleeding, injury, or a tumor.
Normal-pressure hydrocephalus (NPH), which usually develops in people who are age 55 or older. It is a potentially treatable cause of dementia. This type of hydrocephalus often occurs after head trauma, infections, and bleeding within the brain.
Ex-vacuo hydrocephalus, which occurs when there is damage to the brain caused by stroke or traumatic injury. This type of hydrocephalus may not be a health danger for some people, in which case treatment is not needed.
Causes of Hydrocephalus
Cerebrospinal fluid (CSF) flows through your brain and spinal cord in normal conditions. Under certain conditions, the amount of CSF in your brain increases. The amount of CSF can increase when:
A blockage develops that prevents CSF from flowing normally there is a decrease in the ability of blood vessels to absorb it your brain produces an excess amount of it
Too much of this fluid puts your brain under too much pressure. This pressure can cause brain swelling, which can damage your brain tissue.
In some cases, hydrocephalus starts before a baby is born. This can result from:
- a birth defect in which the spinal column doesn’t close
- a genetic abnormality
- certain infections that occur during pregnancy, such as rubella
This condition can also occur in infants, toddlers, and older children due to:
central nervous system infections such as meningitis, especially in babies bleeding in the brain during or shortly after delivery, especially in babies born prematurely injuries that occur before, during, or after delivery head trauma
- central nervous system tumors
- Normal Pressure Hydrocephalus
When hydrocephalus occurs in adults, CSF levels rise but the amount of pressure is usually normal. It still causes the brain to swell and can lead to impaired functioning. In adults, this condition usually results from conditions that prevent CSF from flowing. However, in some cases, there is no known cause.
- You might be at higher risk if you have experienced any of the following:
- brain-related infections such as meningitis
- head injuries
- bleeding from a blood vessel in your brain
- brain surgery
Symptoms of hydrocephalus
Hydrocephalus can cause permanent brain damage, so it’s important that you recognize symptoms of this condition and seek medical attention. The condition is more common in children, but it can happen at any age.
Early signs of hydrocephalus in infants include:
- bulging fontanel, or soft spot on the surface of the skull
- a rapid increase in head circumference
- eyes that are fixed downward
- extreme fussiness
- excessive sleepiness
- poor feeding
- low muscle tone and strength
- Toddlers and Older Children
Symptoms or signs that affect toddlers and older children include:
- short, high-pitched cries
- personality changes
- changes in facial structure
- crossed eyes
- muscle spasms
- delayed growth
- trouble eating
- extreme sleepiness
- loss of coordination
- loss of bladder control
- larger than normal head
- trouble staying awake or waking up
- vomiting or nausea
- problems concentrating
- Young and Middle-Aged Adults
Symptoms in young and middle-aged adults include:
- chronic headaches
- loss of coordination
- difficulty walking
- bladder problems
- vision problems
- poor memory
- difficulty concentrating
Normal Pressure Hydrocephalus (NPH)
This form of the condition usually begins slowly and is more common in adults over the age of 60. One of the earliest signs is falling suddenly without losing consciousness. Other common symptoms of Normal Pressure Hydrocephalus (NPH) include:
- changes in the way you walk
- impaired mental functions, such as memory problems
- trouble controlling urine
- trouble controlling stools
Diagnosis of Hydrocephalus
If child has suspected hydrocephalus, The doctor will perform a physical exam to look for signs and symptoms. In children, doctors check for eyes that are sunken in, slow reflexes, a bulging fontanel, and a head circumference that is larger than normal for their age.
The doctor may also use an ultrasound to get a closer look at the brain. These tests use high-frequency sound waves to create images of the brain.
Magnetic resonance imaging (MRI) scans can be used to look for signs of excess CSF. MRIs use a magnetic field and radio waves to make a cross-sectional image of the brain.
Computerized tomography (CT) scans can also help diagnose hydrocephalus in children and adults. CT scans use several different X-rays to form a cross-sectional image of the brain. These scans can show enlarged brain ventricles that result from too much CSF.
Treatment for Hydrocephalus
- The goal of treatment is to reduce or prevent brain damage by improving the flow of CSF.
- Surgery may be done to remove a blockage,after the medication is not found to be effective.
In most cases, a shunt is surgically inserted. The shunt is a drainage system made of a long tube with a valve. The valve helps CSF flow at a normal rate and in the right direction. Your doctor inserts one end of the tube in your brain and the other end into your chest or abdominal cavity. Excess fluid then drains from the brain and out the other end of the tube, where it can be more easily absorbed. A shunt implant is typically permanent and has to be monitored regularly.
Endoscopic third ventriculostomy (ETV)
An alternative procedure to shunt surgery is an endoscopic third ventriculostomy (ETV).
Instead of inserting a shunt, ETV involves making a hole in the floor of the brain to allow the trapped CSF to escape to the surface of the brain where it can be absorbed.
Cost of Hydrocephalus Surgery
India today is known around the world for its low cost and excellent medical health care services. The treatment for hydrocephalus in India is very cost-effective and have hospitals with latest technology The level of care is much better as compared to other developed countries of the world.