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Neuro and Spine Surgeries

Hydrocephalus

What is Hydrocephalus?

The word ‘Hydrocephalus’ is the situation where there is an exceptional enlargement of the brain ventricles (cavities) due to the aggregation of cerebro-spinal fluid (CSF). Cerebro-spinal fluid is a clear fluid captivated by the brain. This CSF distribute from the brain cavity system and thereafter from the subarachnoid space neighboring the spinal cord and brain. CSF cultivates and conserves both the spinal cord and brain. Damaged to the brain is generate if hydrocephalus is left untreated. It has been view that hydrocephalus is more natural in child and adults who are 60 or above. According to some professional, normal pressure hydrocephalus accounts for 5-6% of all dementia cases.

Types of Hydrocephalus

Hydrocephalus can be categorized into following types –

Normal Pressure Hydrocephalus (NPH): This type of hydrocephalus is usually noticed in adults who are 60 or above. NPH occurs when the amount of cerebro-spinal fluid increases in the ventricles of the brain with no or little increase in the pressure within the head.

Communicating or Non-obstructive Hydrocephalus: This type of hydrocephalus occurs when there is insufficient cerebro-spinal fluid absorption.

Non-communicating or Obstructive Hydrocephalus: This type occurs when there is a blockage of cerebro-spinal fluid in the ventricular system.

Congenital Hydrocephalus: This type of hydrocephalus can occur due to environmental influences at the time of fetal development or also due to genetic factors. It can develop either before or soon after birth.

Causes of normal pressure Hydrocephalus

Head injury

The mechanisms behind normal pressure hydrocephalus are unknown

Tumor

Subarachnoid hemorrhage

Infection such as meningitis

Previous posterior fossa surgery

Congenital causes in infants and adults

Neurofibromatosis

Congenital infections such as toxoplasmosis, cytomegalovirus and rubella.

Aqueductal abnormalities

Dandy-Walker syndrome: A condition where there is enlarged ventricle caused by obstruction in the pathway.

Internal bleeding in the brain or hemorrhage

Arteriovenous malformation such as vein of Galenc

Chiari malformations (type 1 and 2)

Neural tube defects (NTDs) and Spina bifida

Acquired Causes in adults

Infections such as cerebral abscess

Malignant or benign tumors may result in blockage of CSF flow

Head injury

Medication- Infiximab infusion may cause communicating hydrocephalus

Subarachnoid hemorrhage

Idiopathic hydrocephalus

Congenital aqueductal stenosis

Acquired Causes in children and infants

Malignant or benign brain tumors

Infection such as cerebral abscess and bacterial meningitis

Subarachnoid hemorrhage

Leukemic infiltrates of CNS

An increased venous sinus pressure associated with venous thrombosis, craniostenosis and achondroplasia

Symptoms of Hydrocephalus

Hydrocephalus symptoms depend upon the stage of hydrocephalus condition and the age of the child at the time of diagnosis.

Symptoms in Older Children

Urinary incontinence

Severe headaches associated with vomiting and nausea

Sleepiness or chronic lethargy

Sudden changes in personality

Difficulty in focusing and remembering

Poor physical coordination

Double or blurred vision

Problems with balance

Difficulty in walking or standing

Halted or slow development progress in reasoning and speech.

Bouts of irritability with no specific reason

Difficulty in looking upward when the head is facing forward

Swelling of the Optic disc in the optic nerve of the eye

Symptoms in Infants

Unexplained seizures

Unusual large head size

Severe and frequent episodes of vomiting

A sudden increase in the head size

Unable to look upward while the head is facing forward

Diagnosis of Hydrocephalus

Diagnosis of Hydrocephalus is done by performing following tests –

MRI scans

Physical examination

CT scans

Eye examination

Treatment for Hydrocephalus

The treatment for hydrocephalus depends upon the underlying cause. However the treatment includes –

Wait and see approach: When hydrocephalus is found by casualty like at the time of MRI or CT scan inquiry done for some other problem and is not appear in any manifestation. In this case there is a particular treatment for hydrocephalus. Only concerned examination and check is appropriate.

Medication: For instance, at the time of disease antibiotics are given. Surgery is mandatory for clearing up the disease when it do not resolve the hydrocephalus.

Surgery: The surgical proceeding for hydrocephalus can clear away the motivation of the blockage. When there is a situation of provisional hydrocephalus, a specialist may insert a small catheter so as to facilitate the fluid to drain out while the authentic element such as bleeding has time to intention. In the case of inveterate hydrocephalus, a shunt (a permanent tube) is inserted to ditch out the exuberance fluid.

Shunt Operation for Hydrocephalus

Shunt injection proceeding is treated as the most simple surgical strategy for treating hydrocephalus (fluid on the brain). A shunt is essentially a gadget which helps in diverting fluid from the brain into the intestinal cavity and it consume there carefully into the blood stream. The shunt proceeding is behave in the same way in adults, infants and children. During ventricular shunt surgery, a shunt (a thin tube) is implanted inside the brain. The exuberance CSF in the brain tours from this shunt to another body part generally in the midsection. The fluid is then captivated in the blood stream. In order to control the CSF progress, there is a valve within the shunt. This valve also safeguard that the fluid doe not drain immediately.

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