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Hydrocephalus is a dangerous condition that can cause fetal death in the fetus, and inhibition of development in infants. Hydrocephalus can also appear in adults, causing, among others, gait disturbance and dementia. What are the causes and symptoms of hydrocephalus? What is its treatment?

Hydrocephalusindicates an excessive build-up of cerebrospinal fluid in the ventricular system of the brain. Normally, cerebrospinal fluid is produced in the choroid plexuses of the ventricles of the brain (in the amount of about half a liter of fluid per day). It circulates between them and in the subarachnoid space of the brain and spinal cord, where it provides nerve cells with nutrients, protects the brain against mechanical factors and maintains the correct pressure inside the skull. When it fulfills its role, it is absorbed into the blood. Then another portion of the liquid is produced. However, when the balance between fluid production and absorption is disturbed (excessive secretion of cerebrospinal fluid or insufficient resorption of it) or an obstacle to the circulation of the cerebrospinal fluid, hydrocephalus develops.

Hydrocephalus - causes

Hydrocephalusmay bea birth defect . Then it may be one of the symptoms:

  • of the Arnold-Chiari syndrome, i.e. malformation of the hindbrain and skull;
  • of Dandy-Walker syndrome, when the cyst in the posterior cavity of the skull compresses the cyst and the outflow of fluid;
  • congenital narrowing of the brain's water supply (Sylwiusz's water supply);
  • meningeal hernia (most cases);

A common acquired cause of hydrocephalus is meningitis, mainly purulent. Then the pus clogs the places where the cerebral fluid drains away. A barrier that may appear from the circulation of the cerebrospinal fluid may also be a tumor of the central nervous system, which grows in such a way that it compresses or invades the outflow tract of the cerebrospinal fluid. A blood clot (e.g. as a result of an intracranial haemorrhage) can also contribute to impaired circulation of the cerebrospinal fluid.

In adults there is also the so-callednormotensive hydrocephalus , i.e.Hakim syndrome . It is a form of hydrocephalus with normal cerebrospinal fluid pressure.spinal cord (normally with hydrocephalus this pressure rises).

Hydrocephalus - symptoms

  • enlargement of the head circumference;
  • prominence of the frontal bone;
  • bulging of the fontanel (in newborns and infants);
  • widening of the scalp veins;
  • Macewen's symptom (tapping the skull at the junction of the parietal, temporal and occipital bones produces a louder-than-normal sound);
  • "setting sun" symptom (Parinaud's symptom) - when looking up, the eyeballs are pointing down;

In the case of Hakim's syndrome, there is a triad of symptoms:

  • abnormal gait (ataxia)
  • dementia
  • urinary incontinence
Important

Hydrocephalus - serious complications

Increased intracranial pressure that occurs in the course of hydrocephalus may lead to fetal death or severe neurological deficits as well as impaired intellectual and psychomotor development of the child. Common complications of hydrocephalus are hearing and / or vision damage, paresis, epilepsy.

Hydrocephalus - diagnosis

In addition to the physical examination, a number of other tests are performed, such as:

  • transcranial ultrasound;
  • computed tomography of the brain;
  • brain magnetic resonance imaging;
  • cysternography - a test aimed at assessing the circulation of the cerebrospinal fluid;
  • fundus examination;
  • pressure measurement in the ventricles and the spinal canal;
  • CSF test;

Hydrocephalus - treatment

Surgical treatment is usually necessary. If excess fluid is produced, the procedure involves inserting a valve to allow the cerebrospinal fluid to drain. An implanted valve connects the ventricle of the brain to the peritoneal cavity (the ventricular peritoneal valve), where the cerebrospinal fluid is absorbed into the bloodstream. However, such surgery carries the risk of complications such as infection or valve obstruction.

If the circulation of the fluid is impeded, e.g. by a brain tumor, an endoscopic ventriculostomy is performed, i.e. an additional channel through which the fluid can drain.

Other methods of treatment include external drainage or subcutaneous implantation of the so-called Rickham tank connected to the chamber system.

This will be useful to you

Hydrocephalus can be treated in the fetus

Hydrocephalus can already be diagnosed in a fetus during an ultrasound examination. If the diagnosis is made, your doctor may perform an operation in the womb to implant a ventricular-amniotic valve. The treatment protectsthe child against the harmful effects of increased intracranial pressure on the brain and the related serious complications.

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Category:

Neurology