What is Hydrocephalus? A Simple Explanation of This Neurological Disorder

What is Hydrocephalus?
You've seen your doctor, perhaps a neurologist, and you've been asked to undergo some testing to determine whether or not you have a condition called hydrocephalus. Now you have some questions about just what hydrocephalus is and what you will experience during the diagnosing process. What follows is a brief explanation of what hydrocephalus is, in layman's terms, and a description of some of the tests that may be ordered to determine whether or not you have the condition.

Hydrocephalus, generally speaking, means an increased accumulation of fluid in the brain. This fluid is called cerebrospinal fluid, or CSF, which is produced in the ventricles of the brain and circulates through the ventricular system. (The Hydrocephalus Association) The CSF is absorbed into the bloodstream at a rate equal to the rate of the production. When more CSF is produced in the ventricles of the brain than the bloodstream absorbs, an increase of CSF is found in the brain. This condition is called hydrocephalus.

There are two types of hydrocephalus: communicating hydrocephalus (also known as non-obstructive hydrocephalus), and noncommunicating hydrocephalus (or obstructive hydrocephalus). In communicating hydrocephalus, the problem with the absorption of CSF is not caused by any blockage or obstruction of the ventricular pathways. There is some other problem that is impeding the natural absorption of the CSF into the system. In noncommunicating hydrocephalus, there is a blockage of the ventricular pathways that is affecting the flow of CSF through the system. (The Hydrocephalus Foundation, Inc.)

Some patients are born with hydrocephalus. When congenital, the condition is usually detected soon after birth. Other patients acquire hydrocephalus after traumatic occurrences to the brain, such as head injury or brain tumor, or after an illness or infection.

Symptoms of Hydrocephalus
One of the first symptoms of hydrocephalus that many patients experience is a headache, or feelings of increased pressure in the head. Some other symptoms of hydrocephalus may include a decrease in appetite, vomiting, changes in vision, or in the ability to control the movement and position of the eyes, changes in balance and coordination, change in gait, irritability, restlessness, incontinence, personality changes and mental status changes such as confusion or even psychosis. (AllRefer.com/health, National Hydrocephalus Foundation)

Testing for Hydrocephalus
There are some tests that your doctor will most likely order for you if there is a suspicion that you are suffering from hydrocephalus. There may be some obvious physical findings, like an enlargement of all or part of the head, or visibly enlarged veins in the scalp. Depressed eyes and abnormal reflexes are other signs of hydrocephalus.

Generally, the first test ordered for a patient suspected of having hydrocephalus will be a CT scan of the head. If the ventricles are enlarged (a sign of increased CSF in the brain), this will be evident in the head CT scan. A CT scan is a painless radiological exam in which the patient lies flat on a table and is slid into a large donut-like scanner. The CT scan is an open scan, in which only the portion of the body being scanned is enclosed in the machine.

A lumbar puncture, also commonly referred to as a spinal tap, is another test useful for determining hydrocephalus. A lumbar puncture involves the insertion of a needle into the spinal column in order to test the pressure levels of the CSF, and extract some of the CSF from the spinal column for testing. During a lumbar puncture, the patient will lie on his or her side, with the knees drawn up toward the chest. After the injection of am anesthetic agent, like lidocaine, the CSF collection needle is inserted into the spinal column of the lower back. The procedure can take approximately thirty minutes, and is an uncomfortable, and for many, painful procedure.

There are other radiological scans that may be performed to determine whether or not you have hydrocephalus. Some of these scans include an x-ray of the scull, an echoencephalogram (which is a form of ultrasound), or a RHISA scan, which is a nuclear scan, in which small amounts of radioactive material are injected into the CSF in order to detect problems with the CSF circulation.

How is Hydrocephalus Treated?
Some forms of hydrocephalus require no specific treatment, and others are temporary conditions, which can be resolved with short-term intervention. However, hydrocephalus does almost always require lifelong treatment, and usually will require surgical intervention. Medications for hydrocephalus may be tried, but they may have unpleasant side effects and are not often successful. (The Scottish Spina Bifida Association)

In most cases, hydrocephalus is treated by the insertion into the brain of a mechanical device called a shunt. A shunt is a mechanism that will transport excess CSF from the brain to another part of the body, usually the abdomen, where it can be absorbed into the body, thereby removing the excess fluid from the brain and decreasing the pressure caused by hydrocephalus. If for some reason the abdomen is not an appropriate site for the CSF drainage, other types of shunts may be used to drain the CSF into the lung cavity, the atria of the heart, the gallbladder, or the bladder. (National Hydrocephalus Foundation)

Shunts require lifelong maintenance. The average life expectancy of a shunt is about 10 years, but it is important to be aware of the symptoms of shunt malfunctions, and should seek immediate treatment, either from your neurosurgeon, neurologist, or, if necessary, the emergency room of your local hospital. The symptoms of shunt malfunction are the same as the symptoms of hydrocephalus. These symptoms include headache, increased pressure in the head, decrease in appetite, vomiting, changes in vision, or in the ability to control the movement and position of the eyes, changes in balance and coordination, change in gait, irritability, restlessness, incontinence, personality changes and mental status changes such as confusion or even psychosis. (AllRefer.com/health, National Hydrocephalus Foundation)