Hydrocephalus is a condition characterized by an abnormal accumulation of fluid inside the skull that leads to swelling and increased brain pressure. This can happen due to infections of the brain such as meningitis, but also due to the presence of tumors or birth defects, for example.
This fluid, called cerebrospinal fluid (CSF), surrounds the brain and spinal cord and has the function of protecting it. However, when there is a blockage in the passage of the liquid, an increase in the production of the liquid or a malabsorption of it, hydrocephalus occurs which, although it is more frequent in children, can also occur in adults or the elderly.
Hydrocephalus is not always curable, however, it can be treated and controlled through surgery to drain the fluid and relieve pressure on the brain. When left untreated, sequelae of hydrocephalus can include delayed physical and mental development, paralysis or even death.
Types of hydrocephalus
The types of hydrocephalus are related to the causes of hydrocephalus and include:
- Fetal or Congenital Hydrocephalus: occurs in the fetus, due to genetic factors that lead to malformation of the central nervous system, due to drug ingestion by the pregnant woman during pregnancy or to infections during pregnancy, such as toxoplasmosis, syphilis, rubella or cytomegalovirus; Infantile hydrocephalus: it is acquired in childhood and can be caused by brain malformations, tumors or cysts that cause obstruction, being called obstructive or non-communicating hydrocephalus, by hemorrhages, bleeding, trauma or infections of the central nervous system, such as meningitis that cause an imbalance between the production of CSF and its absorption, being called communicating hydrocephalus; Normal Pressure Hydrocephalus: occurs in adults or the elderly, mainly from the age of 65, due to head trauma, stroke, brain tumors, hemorrhage or as a result of diseases such as Alzheimer's. In these cases, there is CSF malabsorption or excess production.
Therefore, it can be said that hydrocephalus is not always curable, as the treatment varies according to the type and cause of hydrocephalus. The cases in which there is a greater chance of cure are those caused by infections, in which the pressure can return to normal after the infection has been properly treated.
Main symptoms
Hydrocephalus symptoms vary according to age, the amount of fluid accumulated and the damage to the brain:
| Under 1 year | Over 1 year old |
| Head larger than normal | Headache |
| Softened and dilated head veins | Difficulty walking |
| Rapid skull growth | Spacing between eyes and strabismus |
| Difficulty in controlling the head | Loss of movements |
| Irritability | Irritability and mood swings |
| Eyes that seem to look down | Slow growth |
| Epileptic attacks | Urinary incontinence |
| Vomiting | Vomiting |
| Somnolence | Learning, speech and memory problems |
The main symptoms of hydrocephalus in adults or the elderly are difficulty walking, urinary incontinence and progressive loss of memory. There is no increase in the size of the head in adults or the elderly, because the skull bones are already developed.
How the treatment is done
The treatment of hydrocephalus can be done with surgery to drain the CSF to another part of the body, such as the abdomen, for example, neuroendoscopy, which uses a thin device to relieve pressure from the brain and circulate fluid or medications to prevent excessive production of CSF.
In addition, there are other surgeries that can be done to treat hydrocephalus, such as surgery to remove tumors or parts of the brain that are producing too much CSF. Therefore, depending on the cause, the neurologist must indicate the appropriate treatment.
Learn more about treating hydrocephalus.
The sooner treatment for hydrocephalus is performed, the less the sequelae will be such as delay in physical and mental development, for example, which can, however, be minimized with physical therapy. A common condition where the child is born with hydrocephalus is in the case of myelomeningocele.
