Hydrocephalus

A health condition in which a fluid buildup occurs in the ventricles (cavities) deep within the brain is called hydrocephalus. Extra fluid makes these ventricles become large and puts pressure on the brain. In normal circumstances, cerebrospinal fluid goes through the ventricles and bathes the spinal cord and brain. However, too much cerebrospinal fluid can damage tissues of the brain and cause symptoms associated with brain function.

This condition may occur at any age but mostly happens in infants and older people over 60 years old. However, there are different treatment options that may lessen the symptoms. For instance, surgery may remove extra fluid and restore healthy cerebrospinal fluid levels in the brain and therapies can manage the symptoms caused by this condition.

Symptoms

The symptoms usually are different among people because it depends on their age. For example:

Infants

The following symptoms commonly occur in infants with hydrocephalus. For example:

A fast increase in head size
A head that is larger than usual
A tense soft spot or bulge on the top of the head
Nausea
Vomiting
Lack of appetite
Seizures
Drowsiness or sluggishness (lethargy)
Irritability
Sunsetting of the eyes (when eyes are fixed downward)
Trouble with strength and muscle tone

Toddlers and Older Children

Sluggishness
Drowsiness
Nausea
Vomiting
Reduced appetite
Poor coordination
Enlarged head
Vision changes (including double or blurred vision)
Headaches
Loss of bladder control
Frequent urination
Balance problems
Abnormal eye movement
Personality changes or irritability
Reduced school performance

Young and Middle-aged Adults

These include:

Lethargy
Headaches
Problems with concentration, thinking, and memory
Vision issues
Frequent urination or loss of bladder control
Difficulty in coordination and balance problems

Older Adults

The following symptoms are common in people over 60 years old with hydrocephalus. For example:

Memory loss
Bladder control problems
Sudden urge to urinate
Walking problems
Problems with balance and coordination
Progressive loss of reasoning skills or thinking

If you experience the following symptoms, immediately contact your healthcare professional. Examples include:

A high-pitched cry
Seizures
Persistent vomiting
Trouble with feeding or sucking

Additionally, there are different health problems that may cause symptoms similar to those of hydrocephalus. That’s why if you notice any of the previous symptoms, you should see a doctor right away.

Causes

The primary cause of this condition is an imbalance between the cerebrospinal fluid that is produced and how much is absorbed in the bloodstream. The tissues that line the ventricles make cerebrospinal fluid and after that, it flows through these ventricles by certain channels. Therefore, it flows into specific spaces that surround the brain and spinal column. This fluid is mainly absorbed by blood vessels in the surface tissues of the brain. However, cerebrospinal fluid plays an important role in brain function. For example:

It allows the brain to float within the skull despite its relatively heavyweight
It prevents injuries by cushioning the brain
Help to remove waste products of the brain’s metabolism
The flow of the cerebrospinal fluid helps maintain pressure within the brain and allows for blood pressure changes in the brain.

In most cases, fluid buildup occurs due to the following reasons. Examples include:

Obstruction – The most common cause of this condition is a partial blockage of the cerebrospinal fluid in the ventricles. This blockage often happens from one ventricle to another or from ventricles to other brain spaces.
Poor absorption – Hydrocephalus occurs due to this reason less common. However, problems with absorption of the cerebrospinal fluid may indicate inflamed brain tissues usually due to injury or disease.
Overproduction – It occurs when cerebrospinal fluid is produced faster than absorbed. However, this cause rarely happens.

Risk Factors

Commonly, the exact cause of hydrocephalus is not known. However, there are some factors that may increase the risk of this condition. For example:

Newborns

This condition may occur before, during, or shortly after birth. When it happens before birth it is called congenital hydrocephalus. Check below some factors that may increase the risk of hydrocephalus in newborns:

Central nervous system development that blocks the cerebrospinal fluid flow
Bleeding that happens within the ventricles (this is a complication of premature birth)
Uterus infection during pregnancy (including syphilis or rubella)

Check below for additional contributing factors:

Brain or spinal cord tumors
Infections of the central nervous system (including bacterial meningitis or mumps)
A stroke or head injury that causes brain bleeding
Other brain injuries

What Are The Possible Complications of Hydrocephalus?

If you are not treating this condition, in most cases it worsens and may lead to learning, developmental, and physical disabilities. Moreover, death also may occur due to this condition. Early diagnosis and treatment help to prevent life-threatening complications.

Diagnosis

Healthcare providers usually diagnose this brain condition based on the following factors. For example:

Symptoms
General physical examination
Neurological examination
Brain-imaging tests

Neurological Examination

There are different types of neurological examination and which one your doctor will perform depends on the age. During this procedure, doctors will ask questions about symptoms and medical history and will perform certain simple tests to check for muscle condition, movement, and function of the sensory abilities.

Imaging Tests

Commonly, the following tests are used to diagnose hydrocephalus. Furthermore, the following tests may identify the underlying cause of the symptoms. Check below some of them:

Ultrasound – This test uses sound waves to produce images of the brain. It also can be used to diagnose hydrocephalus during pregnancy.
MRI (magnetic resonance imaging) – This test uses a magnetic field and radio waves to make detailed images of the brain and other body organs and tissues. This test can show enlarged ventricles, high cerebrospinal fluid levels, and others.
CT (computerized tomography) scans – CT scans use X-rays to make cross-sectional views of the brain. It is a quick and painless test but it shows fewer details compared to MRI scans.

Treatment

The primary treatment for people with hydrocephalus is surgery. There are 2 types of surgery. For example:

Shunt

The most common treatment for people with hydrocephalus is a shunt and it involves a flexible and long tube with a valve that helps drain extra fluid from the brain. This drainage system is inserted during surgery. Commonly, one end of the tube is placed in one of the ventricles of the brain while another end is tunneled to another body part (such as a heart chamber or stomach) that helps absorb extra cerebrospinal fluid easier.

Additionally, those who suffer from hydrocephalus usually require regular monitoring and a shunt system for the rest of their lives.

Endoscopic Third Ventriculostomy

Sometimes, people require this surgery option, which involves a small camera that allows the surgeon to see inside the brain. Thereafter, they will make a hole in the bottom of a ventricle that helps the fluid flow out of the brain.

In addition, both surgeries may cause complications. For instance, a shunt system may interrupt draining or poorly regulate drainage due to blockages, mechanical problems, or infections. Bleeding and infections are the most common complications of ventriculostomy.

However, surgery complications require immediate emergency care. Consult with your healthcare professional for more details.

Frequently Asked Questions

What are the primary causes of hydrocephalus?