Information
excerpted from National Institute of Neurological
Disorders and Stroke http://www.ninds.nih.gov/disorders/hydrocephalus/hydrocephalus.htm
What is Hydrocephalus?
Hydrocephalus is a condition in which
the primary characteristic is excessive accumulation
of fluid in the brain. Although hydrocephalus was
once known as "water on the brain," the
"water" is actually cerebrospinal fluid
(CSF) -- a clear fluid surrounding the brain and spinal
cord. The excessive accumulation of CSF results in
an abnormal dilation of the spaces in the brain called
ventricles. This dilation causes potentially harmful
pressure on the tissues of the brain. Hydrocephalus
may be congenital or acquired. Congenital hydrocephalus
is present at birth and may be caused by genetic abnormalities
or developmental disorders such as spina bifida and
encephalocele. Acquired hydrocephalus develops at
the time of birth or at some point afterward and can
affect individuals of all ages. For example, hydrocephalus
ex-vacuo occurs when there is damage to the brain
caused by stroke or traumatic injury. Normal pressure
hydrocephalus occurs most often among the elderly.
It may result from a subarachnoid hemorrhage, head
trauma, infection, tumor, or complications of surgery,
although many people develop normal pressure hydrocephalus
without an obvious cause. Symptoms of hydrocephalus
vary with age, disease progression, and individual
differences in tolerance to CSF. In infancy, the most
obvious indication of hydrocephalus is often the rapid
increase in head circumstance or an unusually large
head size. In older children and adults, symptoms
may include headache followed by vomiting, nausea,
papilledema (swelling of the optic disk, which is
part of the optic nerve), downward deviation of the
eyes (called "sunsetting"), problems with
balance, poor coordination, gait disturbance, urinary
incontinence, slowing or loss of development (in children),
lethargy, drowsiness, irritability, or other changes
in personality or cognition, including memory loss.
Hydrocephalus is diagnosed through clinical neurological
evaluation and by using cranial imaging techniques
such as ultrasonography, computer tomography (CT),
magnetic resonance imaging (MRI), or pressure-monitoring
techniques.
Is there any
treatment?
Hydrocephalus is most often treated
with the surgical placement of a shunt system. This
system diverts the flow of CSF from a site within
the central nervous system to another area of the
body where it can be absorbed as part of the circulatory
process. A limited number of patients can be treated
with an alternative procedure called third ventriculostomy.
In this procedure, a small hole is made in the floor
of the third ventricle, allowing the CSF to bypass
the obstruction and flow toward the site of resorption
around the surface of the brain.
What is the
prognosis?
The prognosis for patients diagnosed
with hydrocephalus is difficult to predict, although
there is some correlation between the specific cause
of hydrocephalus and the patient's outcome. Prognosis
is further complicated by the presence of associated
disorders, the timeliness of diagnosis, and the success
of treatment. The symptoms of normal pressure hydrocephalus
usually get worse over time if the condition is not
treated, although some people may experience temporary
improvements. If left untreated, progressive hydrocephalus
is fatal, with rare exceptions. The parents of children
with hydrocephalus should be aware that hydrocephalus
poses risks to both cognitive and physical development.
Treatment by an interdisciplinary team of medical
professionals, rehabilitation specialists, and educational
experts is critical to a positive outcome. Many children
diagnosed with the disorder benefit from rehabilitation
therapies and educational interventions, and go on
to lead normal lives with few limitations.
What Research
is being done?
Link
to Hydrocephalus Research page
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