About Hydrocephalus
From the Greek words “hydro” (water) and “cephalus” (head), hydrocephalus is often referred to as ‘water on the brain.’ Patients seeking Hydrocephalus Treatment in Rutherford NJ can benefit from advanced diagnostic and surgical options that help manage this condition effectively.
Rather than water, however, it is the accumulation of cerebrospinal fluid (CSF) that characterizes hydrocephalus.
What Is Hydrocephalus?
At about 6 weeks in utero, the fetus begins to produce cerebrospinal fluid (CSF), a clear liquid surrounding the brain and spinal cord. Normally, this fluid bathes the ventricular system of the brain—the brain includes four ventricles (cavities) connected by narrow pathways—and is then absorbed into the bloodstream.
Hydrocephalus is usually caused by either an obstruction or overproduction of CSF leading to its accumulation and increased intracranial pressure. Families seeking Hydrocephalus Children Treatment in Rutherford NJ often consult with neurosurgeons to explore the safest and most effective approaches for pediatric patients.
There are two other forms of hydrocephalus, which primarily affect adults and do not fit exactly into the categories mentioned above: hydrocephalus ex-vacuo and normal pressure hydrocephalus (NPH).
Hydrocephalus ex-vacuo follows a stroke or traumatic injury that causes brain damage. In these cases, brain tissue may actually shrink.
NPH, which affects an estimated 375,000 older adults, is an abnormal increase of cerebrospinal fluid in the brain’s ventricles that may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery. However, many people develop NPH when none of these factors are present.
Causes of Hydrocephalus
The root causes of hydrocephalus are not completely clear. According to the National Institutes of Health (NIH), there are over 180 possible causes of hydrocephalus.
While it may result from genetic inheritance or developmental disorders, such as those associated with neural tube defects including spina bifida and encephalocele, other possible causes include:
- complications of premature birth;
- diseases such as meningitis, tumors, traumatic head injury, and obesity;
- subarachnoid hemorrhage causing a blockage of fluid.
Hydrocephalus may also be described as ‘communicating’ or ‘non-communicating.’ Communicating hydrocephalus occurs when the flow of CSF is blocked after it exits the ventricles. This form is called communicating because the CSF can still flow between the ventricles, which remain open.
Non-communicating hydrocephalus, also called “obstructive” hydrocephalus, occurs when the flow of CSF is blocked along one or more of the narrow passages connecting the ventricles.
Diagnosing Hydrocephalus
Hydrocephalus is diagnosed through a neurological evaluation and by using cranial imaging techniques.
Consultation
During a consultation, your physician will order the appropriate tests according to a physical exam, the patient’s age, and the suspected issues, such as whether it is communicating or non-communicating hydrocephalus.
It is common for additional tests to be ordered when Normal Pressure Hydrocephalus is suspected (usually seen in adults). We explain more in our article on the different types of hydrocephalus.
How Hydrocephalus Is Diagnosed
The following imaging techniques may be used to evaluate the possibility of hydrocephalus:
- Computed tomography (CT) scanning used to assess the size of cranial ventricles and other structures
- Magnetic resonance imaging (MRI) used to assess the size of cranial ventricles and other structures
- MRI cine – a special MRI technique that estimates the flow of CSF from one ventricle to the next
- Ultrasonography to assess for hemorrhage or progression of infant hydrocephalus
Our physicians always discuss what each test is for and how they are performed, so you and your loved one know what to expect. You can book a consultation if you would like more information.
Hydrocephalus Treatment
Treatment for hydrocephalus has advanced considerably in the last 20 years, although no known cure or prevention yet exists.
Surgery is the only treatment option for hydrocephalus. Surgery outcomes have significantly improved combined with early intervention and advanced diagnostic protocols.
Hydrocephalus is most commonly treated with a brain shunt. In some situations, a non-shunt treatment – an endoscopic third ventriculostomy (ETV) – may be sufficient. We explain both treatment options below.
Prompt and effective treatment of hydrocephalus, on which we pride ourselves at ANA, is the determining factor in long-term prognosis.
What Is Brain Shunt Surgery?
A shunt, which has been used to treat hydrocephalus since the 1950s, is a device that allows excess cerebrospinal fluid (CSF) to get “shunted” (moved) to another area of the body.
As the pressure of CSF increases inside the brain, the one-way valve opens and the excess fluid drains to a downstream cavity.
CSF Shunting Surgery
Are Brain Shunts Permanent?
Hydrocephalus Recovery & Rehabilitation
Our vigilance with our hydrocephalus patients is ongoing. It is important to maintain a close connection with your medical team during your recovery and rehabilitation period after your surgery.
This support system will become especially important in cases of an emergency shunt malfunction or if there is an infection. We educate our patients to become vigilant for any signs of malfunction, which we explain below.
Brain Shunt Surgery: Recovery and Side Effects
After shunt surgery, patients may feel some tenderness, tightness, or aching in related areas, such as in the neck, belly, and around the stitches or staples. Patients may also suffer headaches for a couple of weeks after surgery, and feel fluid moving around their scalp until it heals.
Patients have varying recovery times and levels of pain, which can be managed with medication. Tiredness is common. It is important to rest whenever you feel tired and help the healing process. Movement and light walking also help recovery.
For medication, you should consult your doctor first, whether it’s pain medication, blood thinners, antibiotics, or any other prescription medicine.
Your doctor will monitor your healing and the functioning of your shunt in several follow-up consultations. In some cases, your doctor may need to adjust the shunt valve and the flow of fluid drainage. A scan may also show the shunt needs to be repositioned.
Some possible side effects of shunt placement include blockages, infections, and malfunctions. Patients are taught how to identify if there is an infection or if the shunt isn’t functioning properly. Bleeding can sometimes occur around the shunt, or cerebrospinal fluid (CSF) may leak alongside the shunt.
In some cases, a shunt may need to be replaced or removed. Children especially will have several replacements as they outgrow their shunts. Otherwise, without any problems, a shunt may be left in place for years.
It is advised that patients carry some kind of medical identification to indicate they have a shunt for hydrocephalus. This helps inform healthcare professionals in times of emergency. It is important to have a close connection to your medical team and to respond promptly if something doesn’t feel right.
There are other challenges associated with hydrocephalus, such as behavioral adjustments and learning difficulties. We discuss more in our articles on living with hydrocephalus and raising a child with hydrocephalus. Although there is no cure for hydrocephalus, many people go on to live independent and happy lives.
Recovery Time After Shunt Surgery
Shunt Maintenance After Hydrocephalus Surgery
At ANA, we are focused on the importance of follow-up care after shunt surgery. As part of our shunt maintenance, patients are re-evaluated on a regular basis or as needed in the presence of any post-surgical signs, symptoms or concerns, with or without imaging.
All patients and/or caregivers are educated to understand any shunt-related symptoms and encouraged to contact ANA with any concerns.
Hydrocephalus in Children and Adults
This condition is the most common congenital defect of the brain and spine with 1 in 500 infants born with this condition. Although hydrocephalus can occur in adults, it is more common in children, especially infants, and causes potential damage to the brain.
At ANA, we treat numerous pediatric and adult patients for hydrocephalus. Hydrocephalus may be congenital or acquired.
Congenital hydrocephalus is present at birth and possibly acquired during fetal development or due to genetic abnormalities.
Acquired hydrocephalus occurs at, or some time following, birth. This type of hydrocephalus, which may be caused by injury or disease, can affect individuals of all ages.
It is important to note that some 90% of most diagnosed concussions do not involve a loss of consciousness, and symptoms may not occur until several hours after the episode.
Even when they appear, if it’s sports-related, many young athletes are not forthcoming for fear of activity restrictions. An unconscious athlete or one who regains consciousness quickly may be evaluated further on the sidelines.
Is Hydrocephalus Rare?
Approximately 1 million Americans have hydrocephalus, making it a relatively rare condition. However, with around one in 770 babies born with hydrocephalus, it is similar to down syndrome and more common than getting a brain tumor or spina bifida.
Can Hydrocephalus Be Cured?
While there is no cure for this condition, it is treatable. In 25 years, death rates decreased from 54% to 5%.
ANA is committed to the most comprehensive care for those who come to us from among the 1 million Americans who suffer from this disease.
To learn more about how our caring and dedicated neurosurgeons can help you and your loved one, please call us today. Serving New Jersey, New York, Connecticut and Pennsylvania, Advanced Neurosurgery Associates’ team is ready to help anytime.