Hydrocephalus is a condition that occurs as a result of the accumulation of more than normal amounts of cerebrospinal fluid (CSF) in the cavities called ventricles in the brain. This fluid is a fluid that surrounds the brain and spinal cord, protecting and nourishing them. Hydrocephalus occurs when more of this fluid is produced than normal, its circulation is blocked or its absorption is impaired.
Cerebrospinal fluid plays an important role in maintaining the function of brain cells, maintaining pressure balance and protecting the brain from impacts. However, in the case of hydrocephalus, cerebrospinal fluid accumulates at a faster rate than normal, which can lead to increased pressure and enlargement in the brain. This condition can disrupt the normal function of the brain, damage brain tissue, and lead to severe symptoms.
“Hydrocephalus Can Occur for Different Reasons”
The causes of the appearance of hydrocephalus may include congenital brain structural abnormalities, tumors, infections, cerebral hemorrhages, brain injuries, or complications after neurosurgery.
Symptoms of hydrocephalus can vary depending on age, the area where fluid accumulates, and the severity of the pressure. These symptoms can include headaches, nausea, vomiting, loss of balance, vision problems, behavioral changes, and cognitive problems.
Hydrocephalus is usually diagnosed using a neurological examination and imaging tests. The treatment approach varies depending on the cause of hydrocephalus, its severity, and the age of the patient. Treatment options may include surgical placement of a shunt that directs cerebrospinal fluid outward, removal of the tumor, correction of inhibiting factors, or managing symptoms.
Hydrocephalus can be managed with early detection and appropriate treatment. If left untreated, it can cause serious complications and permanent brain damage, so it is important to seek medical attention when symptoms of this condition are noticed.
What are the Types of Hydrocephalus?
Primary (Congenital) Hydrocephalus: This type of hydrocephalus is a condition that already exists when the baby is born. It can occur as a result of abnormalities that occur during brain development before the baby is born. It can occur for various reasons, such as genetic factors or infections that the expectant mother is exposed to during pregnancy.
Secondary Hydrocephalus: This type of hydrocephalus can be caused by a trauma, infection, tumor, or bleeding. This condition develops as a result of obstruction or disruption of normal fluid circulation in the brain. Symptoms of hydrocephalus can vary depending on age, the location and cause of fluid accumulation.
Causes of Hydrocephalus?
Hydrocephalus occurs as a result of the accumulation of cerebrospinal fluid (CSF) in the cavities called ventricles in the brain more than normal. This accumulation is usually due to an increased production of the fluid, inhibiting its circulation or impaired absorption. Hydrocephalus can have different causes:
Congenital Anomalies: During the development process before the baby is born, hydrocephalus may occur as a result of the brain and spinal cord structures not forming correctly. This condition is called congenital hydrocephalus. Abnormalities in the cerebral ventricles or upstream pathways may be the cause of this type of hydrocephalus.
Blocking of Flow Routes: Obstruction or narrowing of the pathways through which cerebrospinal fluid exits the ventricles and circulates into the brain tissue and spinal cord can lead to hydrocephalus. Discharge pathways can be blocked by tumors, cysts, or inflammatory conditions.
Increased CSF Production: Hydrocephalus may occur as a result of the production of cerebrospinal fluid more than normal. In this case, more fluid than usual accumulates in the ventricles and can create pressure.
Impairment of CSF Absorption: Cerebrospinal fluid contains a circulatory system that must be absorbed by blood vessels and returned to the body. If this circulatory system is affected or disrupted, cerebrospinal fluid can accumulate faster than normal, leading to hydrocephalus.
Trauma and Injuries: Brain traumas, hemorrhages, or complications after neurosurgery can also cause hydrocephalus.
Infections: Infections that affect the brain and spinal cord can increase the risk of hydrocephalus, especially by affecting the circulation or absorption of cerebrospinal fluid.
Brain Tumors: Brain tumors can lead to hydrocephalus by interfering with normal circulation of brain tissue and fluid.
Vascular Anomalies: Abnormalities in the structure of the vessels in the brain can contribute to hydrocephalus.
The causes of hydrocephalus can be complex and vary depending on the situation. The diagnosis and treatment process is based on determining the cause of hydrocephalus and creating an appropriate plan. Early diagnosis and appropriate treatment can reduce the possible complications of hydrocephalus.
What are the Symptoms of Hydrocephalus?
Symptoms of Hydrocephalus in Infants and Young Children
Rapid Growth of the Head: The most common symptom in infants and young children is rapid growth of the head. The soft areas of the skull, called the fontanel, can swell.
Swelling in the Fontanel: Infants may experience significant swelling or stretching of the fontanel (the soft area of the skull).
Eye Problems: Babies’ eyes may look downward (called downward deviation or “eyes looking inward”).
Loss of Appetite and Restlessness: Babies may experience feeding problems, restlessness and oversleeping.
Vomit: Frequent and sudden vomiting may be a sign of hydrocephalus.
Advanced Motor and Developmental Problems: Retardation in motor skills and general development may be observed due to hydrocephalus.
Symptoms of Hydrocephalus in Children and Adults
Headache: Headaches are a common symptom, especially in the morning or after prolonged downtime.
Nausea and Vomiting: Nausea and vomiting may occur with headache.
Vision Problems: Vision problems may occur due to pressure on the optic nerve, such as blurred or double vision.
Balance Problems: Walking difficulties, loss of balance and coordination problems may occur.
Cognitive Problems: Memory problems, difficulty focusing, lack of concentration, and general cognitive impairments may occur.
Urinary Problems: Loss of bladder control or difficulty urinating may occur.
Symptoms can vary depending on the cause of hydrocephalus, the places where fluid accumulates, and the severity of the pressure. If hydrocephalus is suspected, it should be evaluated by a health professional. Early diagnosis and proper treatment can reduce the risk of complications.
Hydrocephalus Diagnostic Methods
The diagnosis of hydrocephalus is usually made by methods such as neurological examination, imaging tests (for example, magnetic resonance imaging – MRI of the brain) and, if necessary, analysis of cerebrospinal fluid.
Neurological Examination: The doctor evaluates the patient’s symptoms and conducts a neurological examination. The size of the head, reflexes, muscle tone, movement abilities and other neurological findings are examined.
Imaging Tests: Brain Magnetic Resonance Imaging (MRI): MRI is the most commonly used method in the diagnosis of hydrocephalus. This imaging technique images in detail the areas where cerebrospinal fluid accumulates, the ventricles and brain tissue.
Computed Tomography (CT): CT scans are used to view brain structures. It can be preferred especially in emergencies or when MRI cannot be performed.
Cerebrospinal Fluid Analysis: In some cases, there may be abnormalities in the cerebrospinal fluid due to hydrocephalus. In this case, a sample of cerebrospinal fluid can be taken and analyzed.
Brain Pressure Measurement: The pressure level of the cerebrospinal fluid can be measured. This measurement can help assess the severity of hydrocephalus.
Brain Scintigraphy: It can be used to demonstrate the circulation and flow of cerebrospinal fluid using radioactive isotopes.
Depending on the cause of hydrocephalus and the patient’s condition, one or more of these diagnostic methods may be used. Once diagnosed, further evaluation may be required to determine the underlying cause of hydrocephalus and establish the appropriate treatment plan. Early detection and accurate diagnosis help to effectively plan treatment and management strategies for hydrocephalus.
Hydrocephalus Treatment Methods
Treatment may vary depending on the severity of the condition, the age of the patient, and the cause of hydrocephalus. Treatment options include surgical placement of a shunt that provides cerebral fluid drainage, surgical removal of a tumor or disabling factors, or managing symptoms caused by hydrocephalus.
Hydrocephalus can have serious consequences if left untreated, so early diagnosis and treatment are important. The treatment approach should usually be planned according to the individual situation and the characteristics of the patient.
Shunt Surgery: The most common treatment for hydrocephalus is the surgical placement of a shunt that redirects cerebrospinal fluid back into normal circulation. This shunt is usually transported through the cerebral ventricle or the site of hydrocephalus into the abdominal cavity or heart cavity. The shunt helps to reduce pressure by preventing the accumulation of fluid.
Endoscopic Third Ventriculostomy: In this surgical method, access to one of the places where cerebrospinal fluid is normally absorbed is provided by a new way. In this way, it is aimed to better absorb the accumulated fluids and improve their circulation.
Treatment of the Cause of Hydrocephalus: If there is a tumor, cyst, or other disabling factor underlying hydrocephalus, this cause may need to be surgically removed or corrected.
Drug Therapy: Some medications can be used to manage the symptoms of hydrocephalus. For example, painkillers can be used for headaches, antiemetics (vomiting medications) can relieve symptoms of nausea and vomiting.
Physical and Rehabilitation Therapies: Physical therapy, speech therapy or cognitive therapies may be recommended to manage motor and cognitive problems caused by hydrocephalus.
Regular Monitoring and Follow-up: Treatment of hydrocephalus covers a long-term process. It is important for patients to be monitored regularly by their doctors and to adjust the treatment plan when necessary.
Treatment of hydrocephalus requires an individualized approach. In order to maximize the quality of life of the patients, the treatment plan is aimed at controlling the symptoms and reducing the potential complications. The treatment approach may vary depending on the type of hydrocephalus, the age of the patient, and the general state of health.