Content
Hydrocephalus is a condition characterized by an abnormal accumulation of fluid inside the skull that leads to swelling and increased brain pressure, which can happen due to brain infections such as meningitis or as a result of tumors or changes during fetal development.
Hydrocephalus is not always curable, however, it can be treated and controlled through surgery to drain the fluid and relieve pressure on the brain. When left untreated, sequelae of hydrocephalus can include delayed physical and mental development, paralysis or even death.
Main symptoms
The symptoms of hydrocephalus vary according to age, the amount of fluid accumulated and the damage to the brain. The following table indicates the main symptoms observed in children under and over 1 year old:
Under 1 year | Over 1 year old |
Head larger than normal | Headache |
Softened and dilated head veins | Difficulty walking |
Rapid skull growth | Spacing between eyes and strabismus |
Difficulty in controlling the head | Loss of movements |
Irritability | Irritability and mood swings |
Eyes that seem to look down | Slow growth |
Epileptic attacks | Urinary incontinence |
Vomiting | Vomiting |
Somnolence | Learning, speech and memory problems |
In the case of adults and the elderly, the symptoms that can be observed are difficulty walking, urinary incontinence and progressive loss of memory. When hydrocephalus occurs at this age, there is no increase in the size of the head, because the bones of the skull are already developed.
Causes of hydrocephalus
Hydrocephalus happens when there is a blockage of the flow of cerebrospinal fluid (CSF), increased production or malabsorption of the same by the body, which can happen due to fetal malformations, the presence of tumors, infections or happen as a result of stroke, for example. According to the cause, hydrocephalus can be classified into three main types:
- Fetal or Congenital Hydrocephalus: occurs in the fetus, due to genetic factors that lead to malformation of the central nervous system, due to the ingestion of drugs by the pregnant woman during pregnancy or infections during pregnancy, such as toxoplasmosis, syphilis, rubella or cytomegalovirus;
- Infantile Hydrocephalus: it is acquired in childhood and can be caused by brain malformations, tumors or cysts that cause obstruction, being called obstructive or non-communicating hydrocephalus, by hemorrhages, bleeding, trauma or infections of the central nervous system, such as meningitis that cause an imbalance between CSF production and its absorption, being called communicating hydrocephalus;
- Normal Pressure Hydrocephalus: occurs in adults or the elderly, mainly over 65 years of age, due to head trauma, stroke, brain tumors, hemorrhage or as a result of diseases such as Alzheimer's. In these cases, there is CSF malabsorption or excess production.
It is important that the cause of hydrocephalus is identified, as it is possible for the neurologist to indicate the most appropriate treatment. In some cases it is possible to achieve a cure, especially in those situations in which hydrocephalus is caused by infection, this is because from the moment the infection is treated, the pressure decreases.
How the treatment is done
The treatment of hydrocephalus can be done with surgery to drain the CSF to another part of the body, such as the abdomen, for example, neuroendoscopy, which uses a thin device to relieve pressure from the brain and circulate fluid or medications to prevent excessive production of CSF.
In addition, there are other surgeries that can be done to treat hydrocephalus, such as surgery to remove tumors or parts of the brain that are producing too much CSF. Therefore, depending on the cause, the neurologist must indicate the appropriate treatment. Understand how hydrocephalus treatment should be done.