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Hydrocephalus - Symptoms, Treatment And Causes

Last Updated: Mar 17, 2022

What is Hydrocephalus?

Hydrocephalus is defined as the buildup of fluids in the ventricles (cavities) which is deep inside in the brain. The excessive fluid increases the size of the cavities and puts immense pressure on the brain. A fluid known as Cerebrospinal fluid flows to the spinal column and the brain. The pressure of excessive cerebrospinal fluid can destroy the brain tissues and causes severe impairments in the brain. Hydrocephalus is common among older adults and infants. Hydrocephalus can be treated by surgery. This is performed to maintain and restore cerebrospinal fluid in the brain.

What are the types of hydrocephalus?

In hydrocephalus, the skull is filled up with fluid thus causing the brain to swell. This is also known as Waterhead baby syndrome as the brain gets filled with cerebrospinal fluid.

These are the types of hydrocephalus:

  • Congenital hydrocephalus: Hydrocephalus is a disease which is present at the time of birth and is the result of environmental factors and complex interactions of genetics. Most of the time, the cause of this disease is not determined. Congenital hydrocephalus is diagnosed before the birth of the baby through regular ultrasounds. If hydrocephalus is recognized in adults then the person might have this disorder since the time of birth and the disease is still considered as congenital and is referred to as compensated hydrocephalus.
  • Acquired hydrocephalus: It is the type of hydrocephalus which most of the times is developed after birth due to neurological conditions. This disease can affect people of any age and is caused by a cyst, head trauma, brain tumour or due to the infection in the central nervous system.
  • Benign External hydrocephalus : The other name for this type of hydrocephalus is also known as external hydrocephalus and is found at the time of birth and occurs when CFS is found outside the brain. The effects of benign hydrocephalus in infants are diagnosed when the head size increases but this go away itself by the age of 18 months.
  • Normal-pressure hydrocephalus : This type of hydrocephalus is the non-communicating form and can happen to any of the ages but it is most common in older people. This may also result in infection, head trauma, tumour, any complicated surgery, subarachnoid haemorrhage.

What are the symptoms of hydrocephalus?

Hydrocephalus is a dangerous disease and can damage the brain permanently, therefore, it is important to recognize the disease as early as possible and take medications properly.

Symptoms of hydrocephalus in infants:

  • Soft spot on the surface of the skull that is bulging fontanelle
  • Increase in the circumference of the head
  • Vomiting
  • Poor feeding
  • Excessive sleep
  • Seizures
  • Low muscle tone

Symptoms of hydrocephalus in children

  • Change in personality
  • Crossed eyes
  • Change in facial structure
  • Headache
  • Delayed growth
  • Trouble in eating
  • Loss of bladder control
  • Loss of coordination
  • Head larger than normal
  • Vomiting
  • Concentrating problems

Symptoms of hydrocephalus in adults

  • Problem in bladder
  • Headache
  • Loss of coordination
  • Problem in walking
  • Poor memory
  • Vision problems
  • Concentration difficulties

What causes hydrocephalus?

Hydrocephalus is usually caused due to an imbalance between the cerebrospinal fluid absorbed into the bloodstream and the amount of cerebrospinal fluid produced.

Excessive cerebrospinal fluid in the cavities occurs due to:

  • Obstruction: Hydrocephalus can also be caused when there is complete or partial obstruction of the flow of cerebrospinal fluid from one cavity to the other space around the brain.
  • Poor absorption: This is less common but it occurs when there is a problem with the mechanism of blood vessels which absorbs cerebral fluid. This occurs due to inflammation of the tissues of the brain mainly because of injury or disease.
  • Overproduction: This is rare and occurs when excess cerebrospinal fluid is created then it can be absorbed by the body.

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How to diagnose hydrocephalus?

If it is suspected that a person or a child has hydrocephalus then the doctor will perform a physical exam at first to check the symptoms. In children, the doctor checks sunken eyes, slow reflexes, the circumference of the head and bulging fontanel. Ultrasound will also be done by the doctor to take a closer look of the brain but these type of ultrasounds can only be done with the babies whose soft spot is still open.

MRI scans are also used to check the signs of excess CSF. Magnetic field and radio waves are used to make a cross-sectional image of the brain.

CT scans also help in getting the images of the brains of adults and children with the use of several X-rays which forms a cross-sectional image of the brain.

How to treat hydrocephalus?

Hydrocephalus should be treated on time or it can become fatal but the damaged brain cannot be reversed back to normal. But the main goal is to prevent the brain to damage further. The treatment of hydrocephalus are as follows:

  • Shunt insertion: In this kind of surgery, the shunt is inserted which is used as a drainage system made up of long tube with a valve thus helping the CSF to flow in the right direction and in the normal rate. In this one end of the tube is inserted in your brain and other ends in the abdominal or chest cavity. The fluid is drained out from the tube’s other end where it is more easily absorbed. The shunt is implanted permanently in the brain and is monitored regularly.
  • Ventriculostomy: This procedure is performed as an alternative to shunt surgery. In this hole is made at the bottom of the ventricle or in between the ventricles thus allowing the CSF to drain out of the brain.

Can someone with Hydrocephalus have a baby?

Yes, it is possible to conceive a baby in Hydrocephalus, as the illness does not affect reproduction. Although one’s impairments can have adverse effects on pregnancy which can cause damage to the fetus. So in short one can have a baby, however, it is important to consult your doctor before future planning.

Summary: It is possible for patients with Hydrocephalus to conceive a baby without any medical complications.

What are the risk factors for hydrocephalus?

  • Tumors or lesions on the spinal cord or brain can lead to hydrocephalus.
  • Infections of the central nervous system like mumps or bacterial meningitis make you more prone to developing Hydrocephalus.
  • Bleeding in the brain due to a head injury or stroke can lead to hydrocephalus.
  • Traumatic brain injury also contributes to developing hydrocephalus.
  • Hydrocephalus in infants can be caused due to abnormal development of the nervous system and infection.

What is hydrocephalus shunt?

Hydrocephalus Shunt is a medical device which is used to relieve the pressure that is caused by the brain due to the accumulation of fluids. Shunting is the surgical process of hydrocephalus which primarily treats the condition of excessive collection of cerebrospinal fluid in the brain’s ventricles.

Is shunt surgery painful?

Shunt surgery is not that much painful, two small tubes and a valve is placed under the skin. The patient might feel headache or tiredness after the surgery.

What are the side effects of a shunt?

  • A shunt is normally a delicate equipment which can normally be malfunctioned as it can be blocked or infected.
  • If a shunt is blocked it can be very serious and leads to the excessive buildup of fluid in the brain and this can cause serious brain damage.
  • If the shunt gets infected there can be symptoms like headache, vomiting, stiffness in the neck, irritability and sleepiness in the babies, high fever, tenderness and redness along the line of a shunt.

Can hydrocephalus be cured?

Till now there is no prevention or cure for hydrocephalus apart from brain surgery. If the disease is detected at an early age then precautions can be taken and early treatments can be done.

Is hydrocephalus considered a disability?

Hydrocephalus is considered as a disability because in most of the cases hydrocephalus is associated with spinal cord or problems in the brain, therefore, it can cause any difficulty in the motor functions of the human body.

What foods help with Hydrocephalus?

Foods are the most important part of the human body's functioning. It helps us provide adequate nutrition for basic working, repair, and maintenance. So here is the list of food items that can help you deal with Hydrocephalus in a better way:

  • Extra virgin olive oil: It helps you reduce blood pressure and cholesterol. It has also shown significant improvement in medical conditions like ischaemic stroke, cognitive impairment, and Alzheimer’s disease.
  • Oily fish: Fishes like salmon, herring, mackerel are great sources of omega-3 which help you boost the overall health of your body and brain.
  • Deep colored fruits and veggies: Consumables like strawberries, blueberries, blackberries, spinach, beetroot, beans are great sources of antioxidants. This helps us build better immunity to other diseases.
  • The good fat: nuts, seeds, avocados, and leafy green vegetables are a great source of polyunsaturated fatty acids and monounsaturated fatty acids. It helps you decrease the risk of depression and dermatitis.
  • Dark chocolate and green tea: Another good source of antioxidants, but one thing an individual needs to keep in mind is that it has high sugar which can be harmful in excess quantities.
Summary: Foods with antioxidants, good fats, and omega 3 fatty acids are great to have for patients with Hydrocephalus.

Can you die from fluid on the brain?

The disease hydrocephalus is a condition in which the brain is filled with cerebrospinal fluid surrounding the cushions and spinal cord. If this is not treated in a limited time then it can also cause brain damage, loss in the mental or physical ability or even death.

What are the complications of hydrocephalus?

Hydrocephalus can result in a lot of intellectual and physical disabilities if not treated on time. The complications depend on underlying development problems, severity of the symptoms and timeline of the treatment & diagnosis.

Can you drive with Hydrocephalus?

During Hydrocephalus, it is the vision that is mostly affected. It will be hard for you to achieve visual acuity, coordination, judgment, and concentration. These components are necessary for controlling automobiles like cars. So it is not a good idea to drive with Hydrocephalus.

Summary: Driving with Hydrocephalus is not advised. As it requires visual abilities which are mostly affected during this illness.

Can you drink alcohol with Hydrocephalus?

There is no scientific evidence that can confirm the effects of alcohol on Hydrocephalus. But since the disease mainly affects the development and functioning of the brain and the vision. Alcohol can have drastic effects.

Furthermore, the effects of alcohol, in general, are quite unsafe to consume, so it is advised not to take it anyway.

Summary: There is no evidence that says that alcohol has effects on the patients of Hydrocephalus. But alcohol impairs your overall sense of vision so it can be unsafe in general.
Summary: Hydrocephalus can be described as an unusual buildup of fluid in the small cavities of the brain. It can have adverse effects on the brain and other parts of the body that have been functioning with the affected sides. It is caused due to imbalance in the production of cerebrospinal fluid. The disease has no cure so far, so your doctor will focus on the management of the disease.

References

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Written ByDr. Arun Sharma MBBS,MS - General Surgery,MCh - Neuro SurgeryNeurosurgery
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