It is estimated that 1 out of every 100,000 babies are born with hydrocephalus, making it a condition that affects thousands of individuals every day. Yet, little is known about this condition. This article contains information ranging from how to identify the condition to what treatment options are available.
Understanding This Condition
What is hydrocephalus? To answer that question, you first need to understand how cerebrospinal fluid works in your brain.
There are four ventricles connected by narrow passages throughout the brain. Cerebrospinal fluid moves through these freely, bathing the brain, then deposits back into the bloodstream in a continuous cycle.
Typically, this fluid acts as a cushion between your brain and your skull. Not only does the fluid protect your brain from harsh impact, but it also acts as part of your immune system. Thus, it protects the brain from infections.
This same fluid also keeps your brain tissue buoyant, delivers nutrients, removes waste and regulates the volume of blood within the brain. Fluid draining is an active part of keeping the layer fresh and at a reasonable size.
Hydrocephalus causes this skull fluid to build up inside of the ventricles but constrains the fluid to the inner part of the brain instead of the outer layer. This build-up can cause an enlarged head as well excess pressure resulting in damaged brain tissues and several impairments in brain function.
Hydrocephalus is most commonly found in infants and those over 60 years of age. However, this condition can occur at any time in a person’s life.
What Are the Symptoms?
Since this condition is mostly found in infants, identifying the symptoms is crucial to their long-term health. The most common signs are changes in the head such as an unusually large-sized cranium, a rapid increase in the size of the head, and a bulging soft spot on the top of the head.
You might also notice a series of physical symptoms, including:
- Unusual vomiting
- Abnormal tiredness
- Abnormal irritability
- A reluctance to eat
- Deficits in muscle tone and strength
- Lessened responsiveness to touch
- Stunted growth
- Eyes continually fixed downwards, which is known as sunsetting of the eyes
Toddlers and older children may also develop this disease, but their symptoms vary from what an infant would experience. Sunsetting of the eyes, an enlarged cranium, and seizures remain the same, but symptoms can also include:
- Constant headaches
- Blurred or double vision
- Unstable balance
- Poor coordination
- Lack of appetite
- A loss of bladder control
- Changes in personality
- Trouble walking or talking
Seek immediate help if your infant or toddler if these symptoms become persistent, or if a seizure occurs. Often, these symptoms are painful, and your child will react in a way that identifies something is wrong.
Although rare, hydrocephalus symptoms can appear in young to middle-aged adults. Later onset hydrocephalus shares much of the same symptoms with those a young child would have, but also comes with a decline in memory.
Adults may notice their concentration is severely affected, as well as a number of other thinking or problem-solving skills. These symptoms are most noticeable in the workplace, making them easier to identify.
Those 60 years of age and older are more susceptible to developing hydrocephalus, but the condition remains less common in later years than it is in early life. Older adults can experience all of the same symptoms described previously but may notice a faster rate of degenerative thinking processes.
Shuffling gait and an increased difficulty walking are also noticeable signs. Elderly individuals with the condition may also experience the feeling of their feet being stuck in one place, unable to move.
What Causes This Condition?
Hydrocephalus is caused by an imbalance of how much cerebrospinal fluid the brain takes in and how much is reabsorbed into the bloodstream. This could be caused by an obstruction that stops the fluid from flowing to another ventricle or the spaces around them. In the event of an obstruction, the condition is called normal pressure hydrocephalus.
Less common is communicating hydrocephalus, which occurs when the mechanisms that enable blood vessels to absorb cerebrospinal fluid incorrectly function. This causes excess fluid to be retained in the ventricles as the brain takes in more than can drain.
Finally, the rarest cause of this condition is an overproduction of fluid. This also causes an excess buildup because the brain cannot reabsorb the fluid faster than it is taken in.
What exactly causes either of these three conditions to occur is usually unknown. However, there are a number of issues that can contribute to or trigger these events. There are risk factors for both newborns and any later stage in life.
Abnormal development of the central nervous system can cause obstructions in the flow of cerebrospinal fluid, starting within the womb. Some infants may experience bleeding within the ventricles, which is a possible complication of premature birth.
Expecting mothers that experience an infection in the uterus also have a higher chance of their child being born with hydrocephalus. These kinds of infections can cause inflammation in fetal brain tissues.
Other Age Groups
There are several factors that contribute to your risk level later in life, as well as in a newborn. These include:
- Lesions or tumors in the brain or spinal cord
- Central nervous system infections, like meningitis or the mumps
- Bleeding in the brain caused by stroke or head injury
- Any traumatic brain injury, such as a severe concussion
Is there Any Way to Prevent This Condition?
While hydrocephalus isn’t something you can entirely prevent, there are a number of ways to reduce the risk of you or your child developing it. Pregnant mothers should follow their doctor’s recommended schedule for checkups and prenatal care. Infectious illnesses should be taken care of with proper vaccinations.
Head injury can be prevented by wearing the appropriate safety equipment whether you are playing a sport or riding a bicycle. Children should always wear their seatbelts or be fastened into an age-appropriate car seat. It is also essential to make sure cribs, strollers, swings, and highchairs meet all safety standards.
You may also want to ask your doctor if you or your child should receive a vaccine for meningitis. Once an incredibly common cause of hydrocephalus, this infection can be picked up at numerous locations from college dorms to other countries where it is common.
Is There Any Form of Treatment?
Yes, this condition is often treated by surgically inserting a shunt system. A hydrocephalus shunt diverts the flow of cerebrospinal fluid from the central nervous system to another area of the body where proper reabsorption can take place.
Shunts are flexible, sturdy plastic tubes that are combined with a catheter and a valve. The catheter is placed inside of one of the brain’s ventricles or into the fluid outside of the spinal cord, while the other end is commonly placed into the abdominal or chest cavity.
Moving the fluid to these other areas of the body allow for them to be absorbed back into the bloodstream, but there are complications that can occur. The shunt system might remove fluids faster than they can be produced, or not fast enough.
Over-draining can cause ventricles to collapse, which could lead to torn blood vessels or a hemorrhage. Under-draining may relieve some pressure, but not nearly enough to treat the condition.
Most shunt valves have an adjustable pressure system in the form of a valve. Since it is under the skin, a magnet is placed on the forehead where the valve is located to activate it. This can reduce the chances of both under and over-draining.
Unfortunately, infections may still occur from the procedure of placing the shunt. This can cause fevers, pain, and soreness. Shunts must be monitored by a doctor periodically, especially when there is suspicion of the system not working correctly.
The success of these shunt systems varies from person to person. Some experience temporary improvements, while others still find the condition worsening over time. Others are fortunate enough to see a near complete recovery.
For the shunt to work, early detection and treatment are crucial. The longer the condition goes untreated, the greater the chance that a shunt will only be able to slow down the progression of damage to the brain.
One group of chiropractors focus on the alignment of the craniocervical junction and its effects on the flow of CSF. It has been observed that drainage abnormalities can occur when there is a structural misalignment where the neck and skull meet, and it has been theorized that restoring normal alignment in this area may improve CSF flow and related conditions like hydrocephalus.
Living with Hydrocephalus
If you, a family member, or someone you know has this condition, then it is important to be supportive of procedures and recovery. Identifying the symptoms early can help save someone’s life, so pay attention for any of the signs of hydrocephalus to appear in someone.
Remember, while the condition primarily affects infants and those over 60 years of age, it can develop at any point in a person’s life. Hydrocephalus is debilitating, but there is help available thanks to the shunt system that doctors employ for their patients with the condition.