Hydrocephalus can affect both adults and children. Expanded cerebral chambers can impair brain functions in hydrocephalus. Although hydrocephalus cannot be cured, it can be treated.
What is hydrocephalus?
According to abbreviationfinder, the clinical picture of hydrocephalus is popularly (according to the German translation of the term hydrocephalus) also referred to as hydrocephalus. Characteristic of the clinical picture of hydrocephalus are enlargements of the so-called ventricles of the brain; These ventricles are spaces that are filled with cerebrospinal fluid.
If babies are affected by hydrocephalus, this can appear visually in the form of an enlarged skull. This is because an infant’s skull bones have not yet fully connected and the skull is expanding due to hydrocephalus.
Hydrocephalus can take a variety of forms in those affected. These different forms differ, for example, with regard to the ventricles that are affected by dilation. Medicine also differentiates between different forms of the disease with regard to the corresponding causes that lead to hydrocephalus.
Causes
There are many possible causes of hydrocephalus. For example, the disease can be caused by the body’s own overproduction of cerebrospinal fluid (also known as liquor). A hydrocephalus can also be caused by a blockage in the connections that exist between the cerebrospinal fluid spaces in healthy people.
A distinction is made between congenital and so-called acquired (i.e. not already congenital) causes of hydrocephalus: Congenital causes of hydrocephalus can include malformations of the brain or skull bones. Various developmental disorders of the brain and genetic defects can also lead to hydrocephalus.
Acquired causes that can underlie hydrocephalus include, for example, injuries to the brain from accidents, inflammation of the brain or cerebral hemorrhage. Thrombosis in the head area or rhesus intolerance can also be acquired causes of hydrocephalus.
Symptoms, Ailments & Signs
Hydrocephalus can initially be recognized by the typical, mostly balloon-shaped swelling of the head. The top of the skull appears partially swollen and can be painful to the touch. Hair growth is often disturbed. The increase in pressure in the skull causes severe headaches, blurred vision and seizures.
Many children suffer severe epileptic seizures in the first few days of life, which are often announced by sweating, tremors and generally unusual behavior. The severe pain combined with the loss of consciousness leads to nausea and vomiting. The visual disturbances can be temporary or permanent, with people seeing double vision or having a blurred vision of their surroundings.
In individual cases, hearing problems develop up to the point of complete deafness of the affected child. In the course of the disease, paralysis and other sensory disturbances may occur in the area of the head and in other regions of the body. Dizziness, gait disturbances and disturbances of consciousness also occur. Those affected repeatedly lose consciousness or even fall into a coma. If hydrocephalus is not treated early, irreversible damage to the brain will inevitably occur. In severe cases, the disease is fatal.
Diagnosis & History
A water head to diagnose, known imaging techniques normally used. These procedures include, for example, ultrasound examinations, computer tomography ( CT ) examinations or magnetic resonance imaging ( MRI ).
Which of these methods is particularly suitable for diagnosing hydrocephalus in an affected person depends, among other things, on the assumed cause of hydrocephalus or the age of a patient: Ultrasound is particularly suitable for newborns because the skullcap is not yet completely closed.
The course of hydrocephalus depends, among other things, on the form of the disease and the therapeutic measures taken. Interindividual courses of hydrocephalus are usually different. Possible first symptoms of hydrocephalus are headaches or nausea. Severe courses can lead to impaired consciousness or coma. Appropriate therapeutic measures can often lead to a significant improvement in symptoms of hydrocephalus (such as gait disorders or bladder emptying disorders).
Complications
The hydrocephalus leads to limitations in brain functions. These can have a negative impact on both the physical and mental state, thereby significantly reducing the patient’s quality of life. The patient’s head is bloated by this disease and appears relatively large.
This also leads to higher pressure in the skull, which can lead to headaches. In many cases, the pain also spreads to other regions of the body and can also lead to various complaints there. Furthermore, those affected suffer from visual disturbances, which can also lead to blurred vision or double vision. In severe cases, epileptic seizures also occur.
As the disease progresses, paralysis and other sensory disturbances occur. The patient’s everyday life is severely restricted by the symptoms. Gait disturbances also occur and patients often lose consciousness or fall into a coma.
The treatment is surgical and usually leads to a positive course of the disease. Complications usually only occur if treatment is not started early and irreversible damage to the brain has occurred.
When should you go to the doctor?
Since hydrocephalus can negatively affect brain functions, this condition must be treated by a doctor in any case. There is no self-healing. In most cases, hydrocephalus is diagnosed by a doctor before birth or immediately after birth. A further visit for diagnosis is therefore usually not necessary. However, a doctor should always be consulted if the child suffers from severe headaches or vomiting. Hydrocephalus can also lead to visual problems as it progresses, so that the patients suffer from double vision or blurred vision. A medical examination is also highly advisable.
The treatment of this disease is usually carried out by different specialists and depends on the exact severity of the complaint. However, complete healing is not achieved. In many cases, the parents or relatives also suffer from severe psychological problems, so that psychological treatment is advisable.
Treatment & Therapy
A frequently used therapeutic method for the treatment of hydrocephalus is the implantation of a shunt: A shunt is a thin tube made of plastic and silicone, which directs brain water from the cerebral chambers to other parts of the body when hydrocephalus is present. For this purpose, the shunt is moved from an affected brain chamber into the abdominal cavity, for example.
The aim of this intervention is to reduce the size of dilated cerebral ventricles. The tube used to relieve the symptoms of hydrocephalus is placed under the skin; the measure carried out is therefore not recognizable from the outside. Shunts can be used to treat hydrocephalus in both adults and children. Depending on the shape, implanted tubes for the treatment of hydrocephalus can have different valves: These valves react, for example, to high or low pressure in the cerebral ventricles.
A therapy for the special lowering of the third cerebral ventricle is the so-called endoscopic third ventriculostomy (ETV); here the brain chamber wall is provided with a minimal hole. Drug therapies to treat hydrocephalus are usually used only rarely and for a short time.
Outlook & Forecast
After an operation, the course of the disease is usually positive. Early diagnosis favors this. It is crucial that there is no lasting damage to the brain. A basic distinction must be made between forecasts for newborns and small children and for adults. Hydrocephalus is not curable; however, it can be successfully treated in most cases. This results in a positive outlook for patients given the current state of medical possibilities.
With timely treatment, children in particular can usually lead a life without further complaints. Studies show the success of the shunt. Two-thirds of them can therefore pursue the same educational path as healthy peers. About every tenth child dies. The others remain with behavioral problems that result from the limitations in brain function. These can be minimized with tutoring and special therapies.
The prospects for adults are unclear. For them, it depends on how they got the disease. You don’t always have to wear a shunt for life. A striking number of senior citizens suffer from hydrocephalus. With increasing age, there is an increased risk after an operation.
Prevention
It is hardly possible to prevent hydrocephalus. However, it can have a positive effect on the course of the disease if hydrocephalus is diagnosed early and can be treated medically accordingly. In many cases, the extent of consequential damage due to the enlarged cerebral ventricles in hydrocephalus can be reduced in this way.
Aftercare
Proper aftercare is also of great importance in such a low-risk operation as the shunt operation. The patient must abstain from food on the day of the operation, particularly if it is a ventriculoperitoneal derivation. Just one day after the procedure, the patients are mobilized by physiotherapy and are allowed to eat and drink normally.
After a few days, the position of the brain catheter and the width of the brain chambers are checked by means of a computer tomographic examination. This is to confirm that the procedure has been performed successfully and is bringing the desired relief to the patient. The patient can then leave the hospital and return to everyday life.
Annual follow-up checks by means of CT examinations and discussion of the existing symptoms must be observed. They uncover possible postoperative complications such as subdural bleeding from overdrainage and, if necessary, enable rapid treatment.
Patients who have experienced such overdrainage can discuss with their doctor the possibility of implanting post-operatively adjustable gravitational valves, which can then be used in the next necessary operation. Shunt insufficiencies due to a blocked catheter are also possible and require immediate correction.
You can do that yourself
Medical therapy is always indicated for the treatment of hydrocephalus. The individual symptoms can be alleviated by those affected by a number of self-help measures.
Epileptic seizures can be reduced by taking preventive measures, for example avoiding possible triggers and using rescue medication helps to avoid seizures. Bed rest and rest help against nausea, vomiting and headaches. In addition, the person affected should adjust their lifestyle to avoid any side effects. If double vision occurs, medical advice is required. As an acute first measure, rest and protection are also recommended here.
In principle, hydrocephalus must be treated surgically. After an operation, a recovery phase of several weeks is indicated. The patient should endeavor to have regular check-ups by the doctor even after the end of the treatment. If complications arise, it is best to go to the hospital immediately.
Since hydrocephalus always represents a psychological burden for those affected, a therapeutic consultation makes sense. Participating in a self-help group can also help those affected to accept the external flaws and any complaints.
