Hydrocephalus

What is hydrocephalus?

Hydrocephalus is the name given to the build-up of excess cerebrospinal fluid in the brain (hydrocephalus means ‘water on the brain’). The function of this substance is to protect the brain, but too much of it puts harmful pressure on the brain. Cerebrospinal fluid also surrounds the spinal cord.

This condition can be congenital, which means that you are born with hydrocephalus or it can be acquired, which means that you develop it after birth as a result of other factors including tumours, infections such as meningitis and bleeding on the brain. This is a common condition in babies with myelomeningocele.

Prognosis of the disease

Hydrocephalus can cause permanent brain damage and problems with physical and mental development. If treated, sufferers can lead a normal life (although with certain limitations) but if left untreated it can be fatal.

The best prognosis for hydrocephalus is for hydrocephalus that is not caused by infection.

Symptoms of hydrocephalus

Symptoms in children can include:

  • Irritability and poor head control
  • Vomiting
  • Drowsiness
  • Eyes that seem to turn downward
  • The child’s head may enlarge more than the face

And in older children and adults:

  • Headaches
  • Balance problems
  • Blurred vision
  • Nausea
  • Problems with thinking and memory

In addition, this pathology in babies causes the soft spot of their head to bulge.

Medical tests for hydrocephalus

A CT scan of the head is performed to diagnose hydrocephalus. This may be accompanied by an MRI scan of the brain and spinal cord, skull ultrasound, lumbar puncture, and x-rays.

What causes hydrocephalus?

Hydrocephalus may be caused by genetic problems or problems in the foetus during pregnancy. Signs of its presence include:

  • Blockage of cerebrospinal fluid flow
  • Cerebrospinal fluid cannot be absorbed into the blood

· The brain produces too much CSF. When this happens, the CSF puts pressure on the brain, pushing it upward and damaging the brain tissue.

Can it be prevented?

In babies, the head can be protected from injury and infections and other disorders associated with hydrocephalus can be avoided.

Treatment for hydrocephalus

Treatment for hydrocephalus depends on the cause. It the cause is a brain tumour blocking the flow of cerebrospinal fluid, then removing the tumour may be the best treatment.

However, most patients with the condition will require a procedure to divert the cerebrospinal fluid away from the brain. They may undergo surgery to implant a shunt, a flexible but robust tube that diverts fluid flow to another area of the body where it can be absorbed.

In some cases, fluid may be rerouted within the brain with an endoscopic third ventriculostomy. The surgeon makes a hole in the floor of the brain to allow the trapped fluid to move away from the surface of the brain where it can be absorbed.

Other complementary measures may include medicines, removal of the parts of the brain that produce CSF, and rehabilitation.

Which specialist treats it?

The specialist responsible for treating it is the neurosurgeon.

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