Initially, ancient physicians believe that hydrocephalus was a build-up of water on the brain. This “water” is actually cerebrospinal fluid that collects in the head.
Hydrocephalus can be categorized by when it occurs: congenital hydrocephalus or acquired hydrocephalus, and by what it does: communicating hydrocephalus or non-communicating hydrocephalus.
Congenital Hydrocephalus
If hydrocephalus develops before birth, it is considered congenital. This form of hydrocephalus has been associated with genetic irregularities, birth defects such as spina bifida and infections that occur in utero.
Acquired Hydrocephalus
Hydrocephalus that occurs at the time of birth or after is labeled acquired hydrocephalus. This form of hydrocephalus can occur in relation to injury, disease, infection, or tumor.
Communicating Hydrocephalus
A network of blood vessels called choroid plexus in the brain’s ventricles (linked cavities in the brain) produce most cerebrospinal fluid (CSF). This colorless fluid then flows throughout the central nervous system, the brain, and spine. CSF can accumulate because of an overproduction of CSF or because of a blockage.
Communicating hydrocephalus is when the CSF flows through the ventricles, “communicating” between ventricles, but becomes blocked once it leaves the ventricles.
Non-communicating Hydrocephalus
When the cerebrospinal fluid becomes blocked between the ventricles, such as in the cerebral aqueduct that connects the fourth and third ventricles, the CSF no longer travels or “communicates” between the ventricles.
What Are the Causes of Hydrocephalus?
If the amount of cerebrospinal fluid generated by the choroid plexus is greater than the amount that the body can absorb, the CSF can accumulate and cause hydrocephalus. CSF serves a number of functions for your brain:
- Protecting and cushioning your brain. Cerebrospinal fluid surrounds the brain and this buffer of liquid helps prevent your brain from crashing into your skull during a head-jarring impact.
- Helping feed your brain. The fluid transports nutrients to your brain and also moves waste away.
- Assisting in maintaining proper cerebral blood flow.
A number of conditions, diseases, and injury can cause an imbalance in the CSF production and reabsorption.
Although congenital hydrocephalus is frequently diagnosed during an ultrasound, treatment outcomes may be better soon after birth to help avoid or curb brain damage. Neural tube defects such as spina bifida can bring on conditions such as Chiari malformations or other spinal cord abnormalities that can result in hydrocephalus.
Congenital hydrocephalus can also occur when the channel between the 3rd and 4th brain ventricle is obstructed, a condition known as aqueductal stenosis.
Acquired hydrocephalus, hydrocephalus that develops after birth, can also stem from several conditions.
Normal Pressure Hydrocephalus (NPH) can develop in older people and is generally idiopathic, or without a known cause.
Symptoms of Hydrocephalus
Signs of hydrocephalus tend to vary with the age of the patient.
Babies still have a growing skull which can increase in size to adapt to an excess of cerebrospinal fluid, however, older children and adults do not have that expandability in their skull bones and their symptoms vary accordingly.
Symptoms of Hydrocephalus in Infants
The most discernible sign of hydrocephalus in a baby is an enlarged head or an accelerated rate of growth to the head’s circumference. Other symptoms may include:
- A bulge or swelling of fluid in the space between bones of the child’s skull
- Extreme drowsiness
- Vomiting
- Seizures
- Eyes cast downward
- Developmental delays
Older Children
Toddlers and older children may also have some of the same symptoms as babies do such as:
- Unusually large head size
- Excessive sleepiness
- Vomiting or nausea
- Developmental delays
Kids with hydrocephalus may also exhibit other symptoms such as:
- Vision issues such as seeing double
- Trouble with balance or coordination
- Irritability
- Declines in developmental abilities
- Headaches
- Personality changes
Adults
Adults may present with somewhat different symptoms due to the lack of malleability of their skull. These symptoms can also indicate normal pressure hydrocephalus.
- Headache
- Balance and coordination issues
- Frequent urination or difficulty controlling bladder
- Deterioration in mental facilities
How Is Hydrocephalus Diagnosed?
Symptoms of hydrocephalus vary from person to person, so your physician will use advanced imaging tools and a neurological evaluation to obtain the most accurate diagnosis.
Congenital hydrocephalus is often discovered during a prenatal ultrasound and is often readily observed in the second trimester and may also be identified with an amniocentesis. After birth, hydrocephalus diagnosis in a newborn may involve magnetic resonance imaging, computed tomography scans, ultrasounds, or CSF pressure monitoring.
Diagnosing normal pressure hydrocephalus in the elderly may require experts familiar with the condition because many of the symptoms mimic dementia-related conditions.
State-of-the-Art Treatments for Hydrocephalus at NSPC in NY
Our private practice of neurosurgeons and allied specialists include neuropsychologists, pediatric neurosurgeons, endovascular neuroradiologists, and neuro-oncologists. Our leading doctors also have appointments as chiefs of neurosurgery in some of Long Island’s best hospitals.
Sometimes hydrocephalus is treated by removing the obstruction to the CSF flow, such as in the instance of a tumor. The most common surgical treatment for hydrocephalus involves installing a shunt system to redirect the excess cerebrospinal fluid (CSF) to a different part of the body to be reabsorbed. A ventriculoperitoneal shunt, also called a VP shunt, is the more common treatment for hydrocephalus.
A third ventriculostomy may be used for certain hydrocephalus cases. This less invasive endoscopic procedure involves creating a tiny hole in the third ventricle allowing the CSF to flow out and away from the brain.
Hydrocephalus in infants and children can lead to severe impairment of neurological function and physical development and requires prompt treatment to prevent brain damage. Our board-certified neurosurgeons who specialize in pediatric neurosurgery offer world-class treatments for brain and spine conditions.
NSPC’s Long Island specialists are well placed to treat hydrocephalus at any stage. We have the technology, expertise, and experience patients look for, and serve New York state and NYC, as well as the wider tri-state area.
