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A diagnosis of Hydrocephalus can be extremely worrying. However, with the right treatment and careful clinical care, you can still lead a relatively normal life for years to come. Here, we explain exactly what your diagnosis means, and what kind of treatment you can expect. At Sophysa, our aim is to provide you with valuable information that you can discuss with your medical team, and what kind of prognosis you may have as a result of new and innovative treatments that are now available, including surgery and implanted shunt systems.
What is happening to me?
You have been diagnosed with Hydrocephalus which is a disease which results from the accumulation of Cerebrospinal Fluid (CSF) into the brain ventricles. There are several types and forms of Hydrocephalus, as well as different therapies and treatments which can include everything from drugs to surgery.
Hydrocephalus is an incurable disease which must be treated permanently to relieve pain and minimize the effect of disorders. Surgery and implantation of a valve (also called a shunt) is one possible treatment.
Before explaining to you what a shunt is, let’s look closer at what Hydrocephalus really means.
The word hydrocephalus comes from two classical Greek words: húdôr (hydro) which means “water” and kephalě (cephalus) which means “head”.
Today, the term hydrocephalus indicates an excess of fluid within the cranium. This is a pathological condition which occurs as a result of an imbalance between the production and absorption of this fluid, the Cerebrospinal Fluid – CSF.
Under normal conditions, circulation and absorption of the CSF create a perfect equilibrium between secretion and absorption of CSF. The average CSF pressure (often called intracranial pressure (ICP)) in adults when lying down is 80-200 mmH2O (6 to 15 mmHg). The pressure is almost zero or even negative when standing up.
But this equilibrium can be disrupted, causing Hydrocephalus. The condition only develops if the CSF is unable to leave the ventricular cavities or if its absorption is disturbed. The excess CSF will remain in the ventricles, which become much bigger.
As the size of the cranium is fixed (except for children up to around 18 months of age in whom the fontanelles are still open), any increase in the volume of fluid within the ventricles affects the brain. This can lead to the development of neurological symptoms due to an increase in the intracranial pressure (ICP), depending on brain compliance for instance.
Symptoms are different between adults and infants, and depend on the patient’s age. Infants and young children, whose cranial bones have not yet completely fused together, will have symptoms different from those of adults.
The clinical manifestations of hydrocephalus occur as a result of ventricular dilatation and of the increased pressure within the cranium.
The usual symptoms of hydrocephalus in infants include:
Depending on the cause, raised intracranial pressure may produce different signs in older children and adults. The major signs are:
Other signs may be found and are systematically looked for by doctors. These include bradycardia or seizures.
The characteristic Hakim’s Triad may be seen in normal pressure hydrocephalus, which is found mostly in adults:
Hydrocephalus is an unpredictable disease, but it can be controlled to relieve pain and disorders. Two medical therapies exist but they are only short-term treatments, which means pain and disorders will be relieved only temporarily and treatment has to be assessed on an ongoing basis.
To control communicating hydrocephalus, surgery is the only truly effective long-term treatment. One of the most effective therapies available is CSF shunting. These have been performed for decades and still represent the most important advance made to date in the treatment of hydrocephalus. A CSF shunt involves establishing an alternative pathway for the movement of CSF in order to bypass an obstruction of the natural pathways.
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