Hydrocephalus In Infants And Adults – Meaning, Causes, 25 Symptoms, Prevention And Best Treatments

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What Is Hydrocephalus?

Hydrocephalus is more prevalent in rural areas of Nigeria and primarily affects infants. Unfortunately, even with treatment, restoring the size of the infant’s head to normal is not always possible.

Several factors influence this outcome, which will be discussed later. This post aims to raise awareness among newbie mothers and provide guidance on efficiently addressing this condition.

Understanding The Condition

Hydrocephalus, a condition characterized by the buildup of excess cerebrospinal fluid (CSF) in the brain’s ventricles, derives its name from the Greek words “hydro” meaning water and “cephalus” meaning the head.

Despite the literal translation as “water on the brain,” hydrocephalus refers to the accumulation of cerebrospinal fluid, a clear liquid surrounding the brain and spinal cord.

The buildup of CSF around the brain can exert harmful pressures on the brain tissues within the skull. This accumulation can be caused by increased fluid production, decreased absorption rate, or an obstruction in the normal flow through the ventricular system.

Early signs may include a bulging fontanelle and an abnormally large head. If left untreated, hydrocephalus can be life-threatening. Treatment options aim to reduce the amount of CSF and are generally effective.

Although hydrocephalus is most common in infants, it can occur in individuals aged 60 and older.

What Are The Causes Of Hydrocephalus?

Hydrocephalus is a neurological condition characterized by an abnormal accumulation of cerebrospinal fluid in the brain’s ventricles. It can occur at any stage of life and may be caused by various factors such as head injuries, strokes, infections, tumors, or brain bleeding. The condition is classified differently based on the age at which it occurs.

Normal Pressure Hydrocephalus (NPH)

Normal Pressure Hydrocephalus (NPH) is a form of hydrocephalus where excessive cerebrospinal fluid (CSF) accumulates in the brain’s ventricles, resulting in enlarged ventricles. Interestingly, NPH is characterized by minimal or no elevation in intracranial pressure (ICP).

The specific reason for the blockage in the absorption of CSF in most NPH cases remains uncertain. This type of hydrocephalus typically manifests in older individuals.

Compensated Hydrocephalus

Compensated hydrocephalus refers to a situation where hydrocephalus was present from birth but did not manifest any symptoms until a later stage in life. This condition can arise due to specific brain tumours obstructing infants’ fourth ventricles.

Acquired Hydrocephalus

Acquired hydrocephalus is a medical condition characterized by the buildup of excessive cerebrospinal fluid in the subarachnoid space of the brain. It can occur either at birth or later in life and is usually a result of injury or illness.

Hydrocephalus Ex-vacuo

Hydrocephalus ex-vacuo is a condition that mainly impacts adults and occurs when degenerative diseases like Alzheimer’s, stroke, or trauma result in brain damage, leading to the shrinking of brain tissue.

Hydrocephalus in children And adults
Image Showing Hydrocephalus in an Infant and an Adult.

Early Symptoms Of Hydrocephalus

I began the “Early Symptoms” section to emphasize that you don’t need to wait for the problem to worsen before taking action.

  • Inadequate appetite
  • Convulsions
  • Restlessness
  • Eyes looking downwards
  • Nausea and vomiting
  • Drowsiness
  • A thin and glossy scalp with easily noticeable veins
  • Swollen and tight fontanelle or soft spot on the baby’s head
  • Stiffness and spasms in the lower limbs
  • Rapidly growing head circumference
  • Abnormally large head size

Symptoms In Young Children and Adults May Include;

  • Throwing up
  • Pain in the head
  • A decline in cognitive abilities/Visual impairments
  • Difficulty remembering things
  • Swelling of the optic disc or papilledema
  • Blurry or double vision
  • Problems with walking or coordination
  • Developmental progress slowing down or regressing
  • Alterations in personality
  • Difficulty focusing or paying attention
  • Seizures
  • Lack of energy or alertness
  • Decreased appetite
  • Inability to control bladder function

Prevention Of Hydrocephalus

I understand that you may be seeking prevention methods for hydrocephalus. Unfortunately, I regret to inform you that there are no specific measures to prevent hydrocephalus. However, there are certain actions you can take to reduce the risk of developing the condition for yourself or your child.

  • Receiving immunizations can aid in the prevention of diseases and infections associated with hydrocephalus. Regular check-ups can also guarantee timely treatment for illnesses or infections that may escalate the risk of developing hydrocephalus.
  • Prenatal care is essential during pregnancy to minimize the risk of premature labour, which can subsequently result in hydrocephalus.
  • Using safety gear, such as helmets, to prevent head injuries while engaging in activities like cycling. Additionally, consistently wearing a seat belt can help reduce the likelihood of head injuries.
  • It is important to properly secure young children in a car seat to guarantee their safety. Also, verifying that baby equipment, such as strollers, adheres to safety standards can effectively prevent head injuries.

Diagnosis

Hydrocephalus can be diagnosed using CT scans and MRI scans. These imaging techniques help identify the presence of congenital hydrocephalus (present from birth) and acquired hydrocephalus (developing later in life).By examining the brain, these scans can reveal fluid build-up, increased pressure, and any structural abnormalities contributing to the condition. In some cases, congenital hydrocephalus can be detected during a prenatal ultrasound.Diagnosing normal pressure hydrocephalus (NPH) can be challenging as its symptoms progress gradually and mimic those of more common conditions like Alzheimer’s disease. Accurate diagnosis is important because NPH symptoms can be alleviated with treatment, unlike Alzheimer’s disease.Doctors evaluate factors such as gait, mental ability, bladder control issues, and brain appearance through scans to diagnose NPH. Symptoms including difficulty walking, mental and bladder problems, and higher-than-usual cerebrospinal fluid (CSF) levels may indicate NPH, though not all symptoms may be present.

Additional tests, such as a lumbar puncture, lumbar drainage test, or lumbar infusion test, may be conducted to determine if surgery is necessary. A lumbar puncture involves extracting a CSF sample from the lower spine to assess pressure.

Surgery may be recommended if removing some CSF during a lumbar puncture improves symptoms. In cases where a lumbar puncture does not yield improvements, a lumbar drain may be inserted to drain a significant amount of

Treatment

Below are various methods through which individuals with hydrocephalus can receive treatment:

Insertion Of A Shunt

Typically, a surgeon will perform a surgical procedure to insert a shunt in most instances. The shunt, composed of a long tube equipped with a valve, aids in facilitating the normal flow and direction of cerebrospinal fluid (CSF).

The doctor places one end of the tube in the brain, while the other is positioned in either the chest or abdominal cavity.

This allows excess fluid to be drained from the brain and easily absorbed through the other end of the tube. It is important to note that shunt implants are usually permanent and necessitate regular monitoring.

Ventriculostomy

Instead of inserting a shunt, surgeons can perform a ventriculostomy procedure as an alternative. This involves creating an opening either at the bottom of a ventricle or between ventricles to allow cerebrospinal fluid (CSF) to exit the brain and alleviate pressure.

However, it’s important to note that Endoscopic third ventriculostomy (ETV) may not suit everyone.

Also, Normal pressure hydrocephalus (NPH) can sometimes be managed with the use of a shunt. However, it should be noted that not all individuals with NPH will experience positive outcomes from shunt surgery.

Given the potential risks associated with shunt surgery, it is crucial to undergo tests that evaluate whether the potential benefits outweigh these risks. Lumbar drainage or a lumbar infusion test, or a combination of both can be employed to determine whether shunt surgery will be advantageous for you.

Recall that, In the earlier part of this text. I mentioned that achieving a normal head shape can be challenging even after treatment. Here’s why: understand that several factors influence the degree to which the head shape can normalize.

These factors include the age at which treatment is initiated, the severity of the hydrocephalus, and the duration of the condition before treatment. If hydrocephalus is not promptly treated or if it is severe, the head shape may not completely return to normal even with treatment.

In such cases, additional approaches like cranial remodelling surgery may be explored to assist in reshaping the skull.

Last Words

Untreated hydrocephalus can lead to fatal consequences, emphasizing the importance of vigilance and taking immediate action upon noticing any symptoms. It is commonly said that prevention is better than cure, new mothers should take proper care during pregnancy and after giving birth.

Infants should also be closely monitored, and adults should know the signs and symptoms. If you suspect that you or someone you know may have hydrocephalus, seeking advice from a healthcare professional experienced in managing this condition is essential.

They can provide guidance on the appropriate treatment options and discuss potential outcomes for each individual case.

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