Hydrocephalus

Hydrocephalus is a condition where there is abnormal accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain. When the circulatory path of the CSF is blocked, CSF accumulates within the ventricles resulting in their enlargement and rise in the intracranial pressure, resulting in hydrocephalus.

There are 3 main types of hydrocephalus:

• Congenital hydrocephalus – hydrocephalus present since birth
• Acquired hydrocephalus – hydrocephalus that develops after birth
• Normal pressure hydrocephalus(NPH) – usually develops in older people

Congenital Hydrocephalus 

If a baby is born with hydrocephalus then it is called congenital hydrocephalus. It can be caused by various conditions. The important ones being, maternal infections during pregnancy and developmental anomalies of central nervous system. Many babies born with hydrocephalus have permanent brain damage.

This can cause several long-term complications, such as:

• Learning disabilities
• Speech problems
• Memory problems
• Developmental disorders
• Vision problems, such as a squint and vision loss
• Epilepsy

Acquired hydrocephalus

Children or adults develop hydrocephalus after an illness or injury.

The common causes leading to acquired hydrocephalus are

• Post meningitis hydrocephalus
• Post head injury hydrocephalus
• Hydrocephalus secondary to brain tumours
• Hydrocephalus secondary to spontaneous intracranial bleeds

Normal pressure hydrocephalus (NPH)

NPH is commonly seen in elderly and most of the time the cause may not be determined. It can sometimes develop after an injury or a stroke. Gait disturbances, dementia and urinary incontinence are the main symptoms of NPH. But because these symptoms happen gradually and are similar to those of other, more common conditions, such as Alzheimer’s disease, NPH can be difficult to diagnose.

Diagnosis: CT and MRI scans of the brain are diagnostic. Hey show dilatation of ventricles as compared to the normal size of ventricles. In addition, one has of look for tumours, meningeal enhancement for meningitis, or evidence of prior head injury.

Treatment:

Shunt placement – a thin tube is placed from the intracranial ventricle to the abdominal cavity to drain out the excess CSF.

Endoscopic third ventriculostomy – a minimally invasive surgery with the help of endoscope, obstructive hydrocephalus beyond third ventricle can be treated.