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Hydrocephalus occurs when there is an excess of fluid in the cavities (ventricles) inside of the brain. The fluid buildup expands the ventricle size and pressurizes the brain. Cerebrospinal fluid (CSF) bathes and cushions the brain and spinal cord. Too much CSF can cause hydrocephalus which can damage the delicate brain tissues causing impairments in brain functions. Hydrocephalus can happen at any age with a higher incidence in infants and older adults. Surgery is the main treatment to restore normal CSF volume in the brain.
The age of onset of hydrocephalus will determine signs and symptoms that will occur.
Infants may have a head that is large or rapidly increasing in size. The soft spot on the top of the head (fontanel) may bulge or be tense. Infants may be irritable, eat poorly, vomit, have failure to thrive, have breathing difficulties, have downward looking eyes or have seizures.
Older children may have headaches, irritability, poor performance in school, eyes fixed downward, double or blurred vision, an abnormally large head, lethargy, nausea, vomiting, poor balance and coordination, failure to thrive or seizures.
Older adults may have cognitive deficits like memory loss, loss of bladder control, loss of coordination or balance, or difficulty walking (shuffling gait).
The causes of hydrocephalus are generally not known. There are developmental or medical problems can contribute to or trigger hydrocephalus.
Hydrocephalus present at birth (congenital) or shortly after birth may occur because of abnormal central nervous system development obstructing the flow of CSF; ventricle bleeding; or uterine infection during pregnancy causing inflammation in fetal brain tissue.
Factors that can cause hydrocephalus in any age include lesions or tumors of the brain or spinal cord, bleeding in the brain, traumatic brain injury, and central nervous system infections such as meningitis or mumps.
Multiple conditions can result in hydrocephalus so it is important for you to get a timely diagnosis with appropriate care. Diagnosis is based on your history and physical exam. A neurological exam will evaluate how you are thinking, how your nerves are working, coordination, movement, muscle strength and reflexes. Imaging will then be performed evaluate for hydrocephalus. Brain imaging may include magnetic resonance imaging (MRI) which uses high powered radio waves to create highly detailed images of the brain; computed tomography (CT) scans which show the bony anatomy and some soft tissue using X-rays and are mainly used for emergency exams; and ultrasound for infants which uses sound waves to create images of the tissue inside of the infant’s head. These exams are used to look for ventricular enlargement which would indicate hydrocephalus.
Because more than one condition can result in the problems associated with hydrocephalus, it is important to get a timely diagnosis and appropriate care.
The most common treatment for hydrocephalus is the surgical insertion of an intracranial drainage system, called a shunt. A long flexible tube is surgically placed within a brain ventricle before being tunneled under the skin into the abdomen or heart chamber to drain. A valve is used to control the flow of CSF away from the brain at a controlled rate. The shunt will usually be needed for the rest of your life to control CSF volume within the brain.
Another treatment is surgical endoscopic third ventriculostomy. A small camera is used to look inside of the brain and a hole is made endoscopically in the bottom of one of the ventricles to allow CSF to drain from the brain.
The Norelle Health neurosurgeons are highly trained and skilled in the diagnosis, management, and treatment of hydrocephalus. Our neurosurgeons can provide the optimal treatment. Neurosurgery is considered essential by insurances and should be covered with your plan. As out-of-network providers, we will check your benefits for you and let you know what they are so there are no surprises. We use an individualized treatment plan for your concerns to provide a personalized holistic plan of care. If you would like assistance, please feel free to contact us (link to contact page) or call our office (link to phone number).