Hydrocephalus is the accumulation of fluid in the brain cavities called ventricles. The excess fluid increases the size of the ventricles and puts pressure on the brain. However, excessive accumulation of cerebrospinal fluid can cause pressure to damage brain tissues. Hydrocephalus can occur at any age but is more common in infants and adults over 60. Shunt surgery is usually performed to manage the symptoms caused by hydrocephalus.
What is Hydrocephalus?
Hydrocephalus can be defined as an increase in the amount of cerebrospinal fluid surrounding the brain. This fluid is of multiple importance to the brain. However, due to various reasons, its increase can raise intracranial pressure and cause serious problems. Hydrocephalus can occur at birth or shortly after. It can also result from damage or injuries to the brain that occur later in life. The human body produces a sufficient amount of cerebrospinal fluid daily and absorbs the same amount through blood vessels. Excess cerebrospinal fluid accumulation can hinder the proper functioning of the brain and can lead to brain damage and even death. Hydrocephalus can be classified into three types:
- Congenital Hydrocephalus: If a baby is born with excessive fluid accumulation in the brain during birth, this condition is called congenital hydrocephalus. Diseases experienced by the mother during pregnancy, such as spina bifida, mumps, and rubella, can be the cause of this congenital defect. Most babies with congenital hydrocephalus may suffer from permanent brain damage. This condition can also bring various symptoms, especially memory problems, difficulty speaking, vision issues, and coordination skill impairments.
- Acquired Hydrocephalus: Hydrocephalus that does not develop congenitally but occurs during childhood or adulthood due to a disease or trauma is called acquired hydrocephalus. This condition can develop due to brain tumors or various traumas.
- Normal Pressure Hydrocephalus: Normal pressure hydrocephalus is a type of hydrocephalus that occurs particularly in adults aged 60 and over and is seen in a rare portion of the population. Although it can occur due to various injuries and traumas, the exact cause is often not determined. Individuals with normal pressure hydrocephalus may face movement problems, urinary incontinence, or memory issues.
What Are the Symptoms of Hydrocephalus?
When hydrocephalus is congenital, it causes distinct physical features in infants. These features include easily visible blood vessels or an abnormally large head. Therefore, it can be easily diagnosed through a physical examination after birth. However, in hydrocephalus that develops later due to an external factor, the symptoms may not be as pronounced. Symptoms such as increased morning headaches or worsening headaches while standing may be observed. Additionally, over time, there may be deteriorations in mental abilities. Especially in normal pressure hydrocephalus, walking disorders may occur. Brain damage caused by hydrocephalus can lead to the following symptoms:
- Enlarged head in infants
- Swelling at the fontanelle
- Vomiting
- Sleepiness
- Infants’ eyes looking downward
- Neck pain
- Vision-related problems
- Developmental delays
- Balance disorders
- Memory loss
- Walking problems
- Forgetfulness
- Urinary incontinence
Individuals who suspect they have symptoms of hydrocephalus should seek medical attention as soon as possible. You can contact our institution to make an appointment to receive support from specialized physicians.
What Are the Causes of Hydrocephalus?
The human brain is surrounded by a fluid called cerebrospinal fluid. This fluid protects the brain from damage, removes waste products from the brain, and provides necessary nutrients for the brain. Therefore, the brain continuously produces this fluid and aims to protect itself. Excess fluid is absorbed by blood vessels, and if there is a problem in this absorption, the fluid accumulates rapidly, creating pressure. The causes of hydrocephalus include:
- Spina bifida
- Premature birth
- Brain hemorrhage
- X chromosome mutation
- Brain trauma
- Infection of the meninges
- Blood clot in the brain
- Various infections
- Stroke
How is Hydrocephalus Diagnosed?
To diagnose hydrocephalus, a neurological examination is required first. During this examination, the doctor may use imaging techniques such as MRI and computed tomography to see inside the skull. Computed tomography can show whether the blood vessels in the brain are dilated or if there is a blockage in these vessels. A test known as lumbar puncture allows doctors to estimate intracranial pressure. This test involves inserting a needle into the lower back to remove some fluid and analyze it. A monitor can also be used to measure intracranial pressure.
How is Hydrocephalus Treated?
Hydrocephalus is a condition that can be fatal if left untreated. Treatments for hydrocephalus aim to reduce the pressure caused by cerebrospinal fluid in the brain. Surgical options are available for the treatment of hydrocephalus. Excess fluid is drained through a tube called a shunt placed in the brain. Hydrocephalus is commonly treated with a shunt surgery. A shunt is a thin tube surgically placed to help drain the fluid causing pressure. The surgeon may also perform a procedure called ventriculostomy as an alternative to placing a shunt. Ventriculostomy aims to remove fluid from the brain by creating a hole under a ventricle or between ventricles.
What is Hydrocephalus Surgery?
A shunt is a drainage system consisting of a long tube with a valve. The valve helps the cerebrospinal fluid flow at a normal rate and in the correct direction. The surgery typically lasts about 1-2 hours. The doctor places one end of the tube in the brain and the other end in the chest or abdominal cavity. The shunt implant is permanent and is a device that requires regular monitoring. When the shunt is placed, it is essential to drain the correct amount of fluid from the brain’s ventricles and ensure that no fluid flows back from the shunt to the brain.
Preoperative Process for Hydrocephalus Surgery
Before the surgery, necessary tests are conducted to learn about the person’s health status. Based on these tests, the doctor plans the surgical process. The doctor may provide information about medications and activities to avoid during the preoperative process.
How is Hydrocephalus Surgery Performed?
The first step for the shunt procedure involves putting the person under general anesthesia. After anesthesia, an incision is made on the patient’s head, and a ventricular shunt is placed in the skull through this incision. This shunt consists of small holes and connects to a valve that regulates the pressure of the cerebrospinal fluid. The valve is then connected to a distal catheter, which is a longer, thinner tube. The distal catheter is used to drain excess fluid taken from around the brain.
Postoperative Process for Hydrocephalus Surgery
After the surgery, the patient needs to stay in the hospital for a few days. During this time, a special nutrition plan is established, and the effects of anesthesia are eliminated from the body. Additionally, medications that need to be taken are prescribed, and information about home care is provided to the patient’s companions. Once the patient starts taking food and fluids, is able to move, and has normal bowel movements, they may be deemed suitable for discharge. After discharge, regular check-ups for the shunt are conducted at intervals.
Frequently Asked Questions About Hydrocephalus
What are the complications of hydrocephalus?
When hydrocephalus occurs, complications such as fatigue, loss of appetite, vomiting, headaches, and developmental delays may develop.
How is hydrocephalus understood?
Hydrocephalus is particularly suspected in newborns when the head is much larger than the body. In children and adults, it can be noticed considering symptoms such as coordination disorders, headaches, and balance problems.
Does hydrocephalus leave damage in the brain?
If hydrocephalus is not treated properly, it can cause permanent brain damage.
What causes hydrocephalus in infants?
Causes of hydrocephalus in infants include premature birth, brain tumors, infections, and congenital defects such as spina bifida.
Does hydrocephalus cause intellectual disability?
If hydrocephalus is not treated, it can lead to mental and developmental problems. These problems can include intellectual and physical developmental delays.
Can hydrocephalus be corrected?
Hydrocephalus can be corrected if treated properly. There are various surgical options available for this treatment. The most effective treatment option is shunt surgery.
Is hydrocephalus surgery risky? How long does it take?
Hydrocephalus surgery can carry risks, as with any surgical procedure. These risks can vary depending on the individual’s health condition. The surgery process typically lasts about 2 hours.
When is the shunt placed in the brain removed or changed?
The shunt placed in the brain may be changed due to the child’s age. As the child grows older, they may need a larger shunt. Additionally, an infection in the shunt can also be a reason for change.
What causes hydrocephalus in the womb?
Hydrocephalus that develops in the womb is a congenital defect. Factors such as problems in the development of the central nervous system and the mother contracting syphilis or rubella during pregnancy can affect the occurrence of this type of hydrocephalus.
What are the symptoms seen in larger babies and children?
Symptoms seen in children may include headaches, blurred vision, abnormal eye movements, loss of balance, loss of appetite, and an abnormally large head compared to the body.
Is there treatment for hydrocephalus?
Hydrocephalus can be treated with the shunt surgery performed. This surgery can alleviate symptoms by draining the excess fluid around the brain.
What are the symptoms in adults and the elderly?
In adults and the elderly, hydrocephalus can cause symptoms such as headaches, fatigue, coordination disorders, loss of balance, and urinary incontinence problems.
Does hydrocephalus cause pain?
Increased intracranial pressure due to hydrocephalus can cause pain. This pain is particularly exacerbated in the mornings and when standing up.
Can hydrocephalus patients walk?
Hydrocephalus patients can walk, but in severe cases, it is also possible for patients to experience walking disorders.
The diagnosis and treatment of hydrocephalus should be carried out by specialized physicians. Hisar Hospital Intercontinental has the necessary expertise in the diagnosis and treatment of hydrocephalus. Individuals wishing to have an examination can make an appointment to carry out their checks.
