Hydrocephalus is a Neurosurgical condition wherein there is an abnormal accumulation of cerebrospinal fluid (CSF) within the brain. Cerebrospinal fluid is a clear, colorless fluid that surrounds the brain and spinal cord, acting as a protective cushion and providing nutrients to the nervous system. It is produced in the brain’s ventricles and normally circulates through the spaces within the brain and the spinal cord, being continuously absorbed and replenished.
In hydrocephalus, there is an imbalance between the production and absorption of CSF, leading to an increased volume of fluid within the brain’s ventricles. This accumulation of CSF can put pressure on the brain tissue, causing enlargement of the ventricles and potentially leading to various neurological problems.
There are two primary types of hydrocephalus:
- Communicating hydrocephalus: In this type, the flow of CSF is obstructed after it exits the ventricles, typically due to issues in the subarachnoid spaces (spaces between the brain and its surrounding membranes). The obstruction prevents CSF from being reabsorbed efficiently, leading to its accumulation.
- Non-communicating hydrocephalus (also known as obstructive hydrocephalus): In this type, there is a physical blockage within the ventricular system, usually caused by congenital malformations, tumors, cysts, or other conditions. The obstruction prevents CSF from flowing freely from the ventricles to other parts of the brain or spinal cord.
What are the symptoms of hydrocephalus?
Symptoms of hydrocephalus can vary depending on the age of onset and the rate of fluid accumulation. In infants and young children, it can cause an enlarged head (macrocephaly), bulging fontanelles (soft spots on the head), vomiting, irritability, and developmental delays. In older children and adults, symptoms may include headaches, difficulty walking, balance issues, cognitive problems, and incontinence.
Hydrocephalus is typically diagnosed through imaging studies like magnetic resonance imaging (MRI) or computed tomography (CT) scans.
How is Hydrocephalus treated?
Treatment often involves surgery directing towards providing alternate pathway for flow of CSF and absorption. This can be in form of:
- Vetriculoperitoneal Shunt: This is the most commonly performed procedure for this condition. In this, a tube is inserted which direct flow of CSF from brain into abdominal cavity from where this gets absorbed.
- Endoscopic third ventriculostomy: In this procedure a pathway is reestablished within cranial cavity so as to direct facilitate flow of CSF and absorption through its natural pathway.
The prognosis for individuals with hydrocephalus can vary, depending on the underlying cause, age of onset, and promptness of diagnosis and treatment. Early detection and appropriate management are crucial for the best possible outcomes. Regular follow-up with healthcare professionals is necessary to monitor the condition and address any complications that may arise.