Causes, types and procedure of hydrocephalus
Causes of Hydrocephalus
In common language, people refer to it as “water on the brain.” Indeed, the name translates to the same thing. It may occur to anyone. One or two babies in one thousand will have hydrocephalus. The intracranial pressure increases due to the excess fluid. This could lead to compression of the brain-stem which could prove life-threatening. Depending on the age of the person and the cause of the blockage, the person may develop a series of symptoms such as vertical gaze palsy and Hakim’s triad of gait instability.
In some cases, infections such as rubella during pregnancy might be the cause of hydrocephalus in the child. It might occur due to infection in toddlers and infants. These infections include meningitis, an infection that affects the central nervous system. Also, it occurs when babies are born prematurely, and bleeding occurs in the brain immediately after birth. Any injury to the baby might bring on the ailment. In children, head enlargement takes place when they have hydrocephalus. This occurs before they are three years old since the cranium bones begin to fuse by the third year.
When hydrocephalus occurs in adults, the amount of CSF increases but the pressure remains normal. The person might experience impaired functioning though there is a chance that the cause of the ailment remains unknown. It is important to find out if there is hydrocephalus and take treatment for it since it might cause permanent brain damage.
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Types of Hydrocephalus
You have four broad types of hydrocephalus.
- Congenital hydrocephalus: This means that the condition is present when the baby is born. The cause is a combination of environmental factors and genetic causes. You can diagnose congenital hydrocephalus before birth using ultrasound.
- Compensated hydrocephalus: You can see this type of hydrocephalus when the person is in his or her adulthood. The chances that they existed since birth is strong.
- Acquired hydrocephalus: In this type, the condition develops well after birth due to other conditions such as a head trauma, intraventricular haemorrhage, infection of the central nervous system, or a brain tumour.
- Normal pressure hydrocephalus: One can see in this case in adults whose ventricles remain enlarged, but the pressure inside in the ventricles does not increase. In most cases, we do not know the cause.
Other than this, you might also see cases of communicating and non-communicating hydrocephalus. When the cerebrospinal fluid (CSF) flows freely throughout the ventricular system of the brain and the subarachnoid space we call the condition as communicating hydrocephalus. If we see any physical block in the form of a tumour, then we call it non-communicating hydrocephalus.
Procedure of Hydrocephalus
You cannot treat hydrocephalus with medicines and one cannot hope for a natural cure either. One may opt for surgery as this is the only option. If left untreated, hydrocephalus can prove fatal. Through this hydrocephalus treatment the surgeon will aim to remove the excess CSF inside the brain. You can do this in two ways.
- Insertion of a shunt: This is the normal way to remove the excess CSF. This drainage system has a long tube and a valve. The doctor will place one end of the tube inside your brain and the other end in the abdominal cavity or the chest. The valve ensures that the fluid flows in the right direction. Fluid remains absorbed with ease in the lower regions of the body than in the brain. Complications could occur when using the shunt. These include overdrainage and underdrainage. Other kinds of problems could also occur such as infection due to exposure. The shunt may experience mechanical failure or a block might occur. In such cases, they will use a replacement.
- Ventriculostomy: The alternative to a shunt is a procedure called ventriculostomy. In this, they make a hole at the bottom of the ventricle. Or, they may make a hole between the ventricles. When this happens, the fluid leaves the brain.
Symptoms, diagnosis and medical tests needed for hydrocephalus
Hydrocephalus can lead to permanent brain damage, so it is important to act fast and recognise the symptoms before it is too late. In infants the signs include a bulging fontanel (the soft spot on the top of the skull), eyes fixed downward, increasing head circumference, vomiting, seizures, low muscle tone, excessive fussiness or sleepiness, and poor feeding.
In slightly older children, one can see changes in the facial structure, shrill cries, personality changes, muscle spasms, headaches, and loss of coordination, irritability, larger than normal head, poor bladder control, vomiting, and trouble staying awake.
In adults, the signs include vomiting, trouble staying awake, vision problems, poor memory, loss of coordination, and trouble concentrating.
The physician does a physical examination to schedule the treatment procedure. Magnetic Resonance Imaging (MRI) scan gives signs of excess CSF. Cross-sectional images of the brain occur by patterning the radio waves with a magnetic field. Computerised tomography (CT) scans can detect the CSF amounts in both adults and children. Here the cross-sectional image occurs from different X-rays. With this, you can detect enlarged brain ventricles.
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Factors affecting the cost of treatment of hydrocephalus
The things that will affect the cost of the treatment include the following:
- The main factor affecting the cost of treatment is the method you adopt.
- If you adopt the shunt method of treatment, then there is a chance of infection. If this happens, the cost of the treatment will increase.
- About 50% of the shunts fail within 2 years. So, you have a recurring expense to bear.
- You might experience a shunt malfunction. A partial or complete blockage of the shunt might necessitate re-installation of the shunt.
- The hospital where the patient takes treatment.
- The type of room – single, double, air-conditioned room.
- Nursing fee, meals, and room service.
- Fees for doctors including the surgeons, physiotherapist, anaesthetist, and dietician.
- Fee for diagnostic tests.
- Operating room and ICU charges.