Hydrocephalus, Causes, Signs and Symptoms, Diagnosis and Treatment.

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Chapters

0:00 Introduction
1:00 Types and Causes of Hydrocephalus
2:48 Symptoms of Hydrocephalus
3:58 Diagnosis of Hydrocephalus
4:30 Treatment of Hydrocephalus

Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain.[1] This typically causes increased pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and downward pointing of the eyes.[1]

Hydrocephalus can occur due to birth defects or be acquired later in life.[1] Associated birth defects include neural tube defects and those that result in aqueductal stenosis.[1][4] Other causes include meningitis, brain tumors, traumatic brain injury, intraventricular hemorrhage, and subarachnoid hemorrhage. The four types of hydrocephalus are communicating, noncommunicating, ex vacuo, and normal pressure. Diagnosis is typically made by physical examination and medical imaging.[1]

Hydrocephalus is typically treated by the surgical placement of a shunt system.[1] A procedure called a third ventriculostomy is an option in some people.[1] Complications from shunts may include overdrainage, underdrainage, mechanical failure, infection, or obstruction.[1] This may require replacement.[1] Outcomes are variable, but many people with shunts live normal lives.[1] Without treatment, death or permanent disability may occur.[1]

About one to two per 1,000 newborns have hydrocephalus.[1][3] Rates in the developing world may be higher.[5] Normal pressure hydrocephalus is estimated to affect about 5 per 100,000 people, with rates increasing with age.[6] Description of hydrocephalus by Hippocrates dates back more than 2,000 years.[5] The word hydrocephalus is from the Greek ὕδωρ, hydōr, meaning 'water' and κεφαλή, kephalē, meaning 'head'.[7] The clinical presentation of hydrocephalus varies with chronicity. Acute dilatation of the ventricular system is more likely to manifest with the nonspecific signs and symptoms of increased intracranial pressure (ICP). By contrast, chronic dilatation (especially in the elderly population) may have a more insidious onset presenting, for instance, with Hakim's triad (Adams' triad).[citation needed]

Symptoms of increased ICP may include headaches, vomiting, nausea, papilledema, sleepiness, or coma. With increased levels of CSF, there have been cases of hearing loss due to CSF creating pressure on the auditory pathways or disrupting the communication of inner ear fluid.[8] Elevated ICP of different etiologies have been linked to sensorineural hearing loss (SNHL). Transient SNHL has been reported after the loss of CSF with shunt surgeries.[9] Hearing loss is a rare but well-known sequela of procedures resulting in CSF loss.[8] Elevated ICP may result in uncal or tonsillar herniation, with resulting life-threatening brain stem compression.[citation needed]

Hakim's triad of gait instability, urinary incontinence, and dementia is a relatively typical manifestation of the distinct entity normal-pressure hydrocephalus. Focal neurological deficits may also occur, such as abducens nerve palsy and vertical gaze palsy (Parinaud syndrome due to compression of the quadrigeminal plate, where the neural centers coordinating the conjugated vertical eye movement are located). The symptoms depend on the cause of the blockage, the person's age, and how much brain tissue has been damaged by the swelling.[citation needed]

In infants with hydrocephalus, CSF builds up in the central nervous system (CNS), causing the fontanelle (soft spot) to bulge and the head to be larger than expected. Early symptoms may also include:[citation needed]

Eyes that appear to gaze downward
Irritability
Seizures
Separated sutures
Sleepiness
Vomiting

Symptoms that may occur in older children can include:[citation needed]

Brief, shrill, high-pitched cry
Changes in personality, memory, or the ability to reason or think
Changes in facial appearance and eye spacing (craniofacial disproportion)
Crossed eyes or uncontrolled eye movements
Difficulty feeding
Excessive sleepiness
Headaches
Irritability, poor temper control
Loss of bladder control (urinary incontinence)
Loss of coordination and trouble walking
Muscle spasticity (spasm)
Slow growth (child 0–5 years)
Delayed milestones
Failure to thrive
Slow or restricted movement
Vomiting[10]

Because hydrocephalus can injure the brain, thought and behavior may be adversely affected. Learning disabilities, including short-term memory loss, are common among those with hydrocephalus, who tend to score better on verbal IQ than on performance IQ, which is thought to reflect the distribution of nerve damage to the brain.

[MatildeG]

As a person who was born with congenital hydrocephalus, I appreciate you making this video! My shunt is working fine, so I hope anyone with hydrocephalus lives a long life!

[viama]

I have a school report about hydrocephalus and this video is really a great help. Thank you very much!

[drviggardanviggardan]

My son was diagnosed with this hydrocephalus and shunt kept in 2018
He has not able to sit and stand
Please update the next step to treatment..
VIGGARDAN from India

[hell_cat]

i got hydrocephalus at the age 12 but thankfully my shunt is working fine till now at 18

[Bruiser]

I have hydrocephalus and spina bifida and a shunt

[jyrich]

I’m 32 I’ve been having problems with cognition for 17 years my MRI has come back normal other than a 6mm pineal cyst which the UK drs have said is benign and won’t cause issues, could this be the root cause of my Brian function decline ?
Thanks James

[anjachan]

congenital hydrocephalus ... I got spina bifida too.

[innocentgirl]

Sir Mery bro Ku vomiting ni stop ho rhi 2nd time uska operation huwa VP shunt Dali ha again please vomiting Q hoti or USka treatment BTa den

[abbysworld]

When I moved to a apartment a few months ago, I saw pictures I’ve never seen before, like my stitches from after my brain surgery and what my head looked like compared to my twin brother, obviously it was taken after my surgery cuz before my surgery I couldn’t move without crying, and I found out they found out I needed brain surgery at my checkup cuz it was a 6 month checkup from being home from the Nique cuz I was born 3 months early and I developed it some time after born, my mom said I got the surgery in either February, March, or April, and since they caught it in time, they were able to wait until the next day, how my mom explains it is that she said that hydrocephalus is always an emergency, however, they caught it early enough to were it wasent an emergency that much, it was still an emergency but we could wait until the next day since it was caught before it would cause irreversible brain damage, and from a video I was able to see my bald spot from the IV used in the Nique, I just think how it would suck if I was a guy cuz I would have to look like my uncle Rick cuz I’ve never seen his hair short cuz if I was a guy I would need to keep my hair long just like I do now but the difference is that it’s expected that girls have longer hair anyway and I like my hair longer anyway but when I see my friends with boy like hair I go I could never do that unless I want people to see my bald spot

[skrzey]

Can hydrocephalus cause paleness in face?

[kayker]

the look on that surgical techs face is so scary

[NaluyangeFina]

Please i need some help my kid doesn't sit, stand, talk, now four years please help

[arbabshafique]

My son die with this problem with the age of 6 and he conduct 5 operation