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Tuesday, May 9, 2017

Hydrocephalus

What is Hydrocephalus?

Hydrocephalus is the abnormal accumulation of fluid (Cerebrospinal fluid) within the cavities (ventricles) of the brain. Cerebrospinal fluid or CSF is normally produced in the ventricles and absorbed such that there is almost a constant volume of the fluid in a normal person.

When there is an imbalance between the production and absorption of the CSF, it results in Hydrocephalus

Who is at risk of developing Hydrocephalus?

Hydrocephalus can occur at any age depending on the cause. However, it is most common in infants and older children. The exact incidence in India is not known. In the United States, of 1000 babies born, 1-2 develop Hydrocephalus.

What are the symptoms?

Infants

  1. Unusually large head
  2. Rapid increase in the size of the head
  3. Bulging or tense fontanelle
  4. Vomiting
  5. Poor feeding
  6. Irritability
  7. Eyes fixed downwards
  8. Delayed milestones
Children
  1. Excessive sleepiness
  2. Irritability
  3. Declining school performance
  4. Headache, vomiting
  5. Double vision or blurred vision
  6. Difficulty in concentrating on routine tasks
Adults
  1. Urinary incontinence
  2. Imbalance while walking
  3. Memory loss
How is Hydrocephalus diagnosed?

After a thorough history and physical examination by the attending Neurologist/Neurosurgeon, one of the following tests may be performed to confirm the diagnosis
  1. Ultrasound imaging in newborns and infants
  2. Computed Tomography (CT)
  3. Magnetic Resonance Imaging (MRI)
How is Hydrocephalus treated?

Depending upon the severity and cause of hydrocephalus, your Neurosurgeon may recommend the following 
  1. Ventriculoperitoneal Shunt surgery - This surgery involves inserting a tube in the ventricles of the brain and placing it in the abdomen so that the excess fluid is drained into the abdomen where it is absorbed by the peritoneum
  2. Endoscopic Third Ventriculostomy (ETV) - In this procedure, the neurosurgeon uses a video camera to make a hole in the ventricle so that excess fluid is drained into the subarachnoid space where it is absorbed.
  3. Close observation - In rare cases, when the hydrocephalus is mild and the cause has been treated, one may just closely follow-up the serial imaging. If the cause has been treated, hydrocephalus may resolve on its own