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Hydrocephalus

Hydrocephalus, characterized by an imbalance in cerebrospinal fluid production and absorption, affects people of all ages. Congenital cases may arise from birth defects, while acquired cases can result from infections or tumors. Timely diagnosis and intervention, often through shunt placement or endoscopic procedures, are critical for managing symptoms and preventing complications. Despite its challenges, many individuals with hydrocephalus lead fulfilling lives with proper medical care and support.

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Hydrocephalus

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  1. What is hydrocephalus? • Commonly known as water in the brain • It is an abnormal accumulation of cerebrospinal fluid (CSF) within the cavities called ventricles inside the brain.

  2. Cerebrospinal fluid (CSF)- is a liquid produced by the chorid plexius found with in the ventricles of the brain. It surrounds the brain and spinal cord, acting as a protective cushion against injury.

  3. Symptoms • Baby’s head abnormally enlarges • soft spot(fontanel) may be tense & bulging • scalp may look thin & glistening • delayed mental development

  4. Continued Symptoms • Scalp veins may have unusual fullness • Feeling baby’s head along sutures bones are separated • Vomiting • Sleepiness • Irritability • Downward deviation of the eyes

  5. Causes • Aqueductal obstruction • Neural Tube Defects or myelomeningocele • Intraventricular hemorrhage • Meningitis • Head trauma • Tumors • Arachnoid Cysts • Dandy Walkers Syndrome

  6. Hydrocephalus may lead to • Mental retardation or brain damage • Epileptic seizures • Neurological injury • Progressive dementia • and Death

  7. Ultrasound Computed Tomography (CT Scans) Diagnosing

  8. Prevention • Prenatal Hydrocephalus is congenital therefore not preventable, but it can be treated . • If left untreated or in extreme cases may lead to death.

  9. Treatment • Open fetal surgery • Shunt placement • Ventriculostomy • There are drugs like acetazolamide, glycerol, furosemide, digoxin& isosobride to postpone surgical placement of a shunt.

  10. Shunt Placement • A shunt is a flexible tube about 1/8” in diameter, and is made of soft and pliable plastic usually silastic • Shunts divert the flow of CSF from the ventricles into the body usually the abdominal cavity or atrium • Shunts are placed into the child’s CSF system, and have a catheter (tubing) and a flow control mechanism (one way valve) • Most shunts have an access area where testing can be done with a fine gauge needle • One portion of the tube is inserted into the ventricles and is called the ventricular catheter • Then the peritoneal/atrium catheter is inserted into the peritoneal cavity or the atrium • A valve regulates the pressure of the CSF flow and prevents backward flow of into the ventricles • There are 6 different types of shunts.

  11. After shunt care • Regular Follow up visits with the Drs • shunt site should be cleaned • eyes examined regularly • CSF pressure should be checked to make sure shunt is working • CSF should be checked periodically to be sure there Is no infection

  12. Risks of a Shunt • Possible bleeding under the outermost covering of the brain known as subdural hematoma • Infection (may cause loss of intelligence) • Stroke • Shunt failure/malfunction • Abdominal injury • Over drainage of the ventricles • Death

  13. Enlargement of head Fontanel is tense, and upright Prominent scalp veins Swelling along shunt tract Vomiting Irritability Sleepiness Downward deviation of the eyes Less interest in feeding Fever Redness along the shunt tract Shunt malfunction or infection

  14. Outcomes of shunt • Complications occur in about 30 % of patients, but only 5% are serious or long term. • 25% to 80% of patients experience long term improvement

  15. ConclusionIn conclusion, congenital and acquired Hydrocephalus is a condition not a disease, it may not be prevented, but it can be treated. If left untreated it may cause many disabilities, complications, and even death.

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