Hydrocephalus (patient information)

Hydrocephalus is a condition in which the brain swells due to a build up of fluid inside the skull. Hydrocephalus literally means “water on the brain.” Hydrocephalus is dangerous and requires immediate medical attention. 60% of people who do not seek medical treatment die.

Symptoms of Hydrocephalus can vary from person to person and usually depend on age, severity, and cause.

Infants:

• Bulging soft spot (fontanelle)
• Larger than normal head size
• Seizures
• Vomiting
• Constant tiredness
• Irritability
• Gaps between skull bones
• Eyes that are constantly looking down

Older children:

• Headache
• Irritability
• Tantrums
• Constant tiredness
• Shrill cries
• Changes in ability to think or act
• Personality changes
• Uncontrollable eye movements
• Changes in eye shape
• Double vision
• Changes in appearance of facial features or shape
• Trouble coordinating motor movements
• Difficulty walking
• Slowed growth
• Trouble eating
• Muscle spasms
• Loss of bladder control
• Nausea

There is a layer of fluid called cerebrospinal fluid (CSF) that surrounds the brain and spinal cord and creates a cushion between the brain and the skull. Normally the CSF flows in and around the brain providing nutrients and oxygen before getting reabsorbed by the bloodstream but, when something goes wrong the CSF may begin to build up and put pressure on the brain.

Many times the cause of hydrocephalus remains unknown. But some of the known causes include the following:

Causes of CSF blockage include:

• Traumatic brain injury (TBI)
• Tumors
• Genetic defects
• In-utero infections
• Bleeding in the brain in premature infants
• Meningitis
• Other infections contracted after birth

Premature babies are often at higher risk.

To diagnosis Hydrocephalus the following tests are usually employed:

• CT scan
• Physical examination performed by a doctor
• Head size measurements to see if the head is getting bigger over time
• X-ray
• Arteriography
• Cranial ultrasound
• Brain scan using radioisotopes
• Lumbar puncture

Seek medical attention IMMEDIATELY if you suspect hydrocephalus or see any of the signs or symptoms listed above. Hydrocephalus is a severe condition that could result in death if left untreated

Treatment options include:

• Surgery to insert a shunt: which sends CSF to another part of the body to reduce the build up in the brain
• Endoscopic third ventriculostomy (ETV): a procedure done to relieve pressure in the brain
• Antibiotics: if an infection is the cause of the hydrocephalus
• Removing areas of the brain that produce CSF

If brain damage has occurred because of Hydrocephalus children may receive follow-up services to assist with their disabilities.

Directions to Hospitals Treating Hydrocephalus

• Prevent trauma to the brain of infants and children: make sure their heads are protected to prevent TBI
• Immediate treatment of infections that could lead to Hydrocephalus

Prognosis is poor if Hydrocephalus is left untreated and usually results in death. Prognosis is also poor for individuals with brain tumors or severe infections.

Even individuals that recover from Hydrocephalus may face permanent brain damage that can lead to both physical and mental disabilities.

Complications can include:

• Surgery complications
• Complications with the shunt following surgery in which the shunt becomes blocked and ceases to drain the CSF adequately
• Mental disabilities
• Physical disabilities
• Neurological impairments
• Infections

• http://www.nlm.nih.gov/medlineplus/ency/article/001571.htm

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