What You Need To Know
- Hydrocephalus is the accumulation of too much fluid in the brain and spinal cord.
- Hydrocephalus is not a disease but a condition and has several causes.
- Congenital hydrocephalus occurs in one or two of every 1,000 babies born in the U.S.
- Hydrocephalus is the most common reason for brain surgery in children.
- Hydrocephalus comes from Greek words hydro, meaning water, and cephalus, meaning head.
Older Child Or Adult Symptoms
Symptoms of hydrocephalus in adults and children may present as nausea, vomiting preceded by a headache, double or blurred vision, “sunsetting” sign, unsteady balance, problems with coordination, difficulty walking, urinary incontinence, drowsiness, lethargy, changes in personality or the capability to think, reason and remember.
What Is The Outlook For A Person With Hydrocephalus
The outlook for someone with hydrocephalus depends largely on the extent of the symptoms. Many children experience lifelong brain damage. By working with professionals including pediatricians, special education teachers, mental health providers, occupational therapists, developmental therapists, and pediatric neurologists, children can learn to manage their disability and lessen the lifelong effects.
Adults with severe symptoms of hydrocephalus might need to work with occupational therapists. Others may require long-term care. Some might need the care of medical specialists who focus on dementia.
The long-term effects of this condition vary widely, depending on individual circumstances. Talk to your doctor for a more case-specific outlook.
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Can A Babys Brain Recover After An Insult
Not only do baby brains recover to some extent after an early insult, but they also continue to grow and change with experience throughout life. The problem that neuroplasticity presents is that this one concept changes many of the underlying assumptions of the field and demands an entirely new model of care for children.
How Is Hydrocephalus Treated
Treatment for hydrocephalus depends on the child’s age and what’s causing the hydrocephalus.
Treatments may include one of these surgeries:
- Ventriculoperitoneal shunt surgery: Doctors place a tube from the brain’s ventricles to the peritoneal cavity, the space inside the belly where the stomach and the bowels sit. The tube is all inside the body under the skin. After it gets to the belly, the extra CSF is absorbed into the bloodstream. Shunts are replaced:
- over time as a child grows and needs a bigger shunt
- if they get infected or stop working
Kids also might need therapy for slowed development, such as:
- an early intervention program
- occupational therapy
Medical Definition Of Water On The Brain
- Medical Editor: Jay W. Marks, MD
Reviewed on 6/3/2021
Water on the brain: Known medically as “hydrocephalus“, this is an abnormal buildup of cerebrospinal fluid in the ventricles of the brain. The fluid is often under increased pressure and can compress and damage the brain.
Hydrocephalus can arise before birth or any time afterward. It may be due to many causes including a birth defect, hemorrhage into the brain, infection, meningitis, tumor, or head injury. Most forms of hydrocephalus are the result of obstructed CSF flow in the ventricular system. With birth defects, physical obstruction of CSF flow in the ventricular system is usually the cause of the hydrocephalus. Hydrocephalus is a common companion of spina bifida .
What is termed “hydrocephalus ex-vacuo” occurs when there is damage to the brain caused by stroke or injury, and there may be an actual shrinkage of brain substance. “Hydrocephalus ex-vacuo” is essentially only hydrocephalus by default the CSF pressure itself is normal.
Normal pressure hydrocephalus can also occur due to a gradual blockage of the CSF drainage pathways in the brain. Although the ventricles enlarge, the pressure of the CSF remains within normal range. NPH is characterized by memory loss , gait disorder of balance, urinary incontinence and a general slowing of activity.
In old age or persons with Alzheimer’s disease, the entire brain may shrink and the CSF fills up the space created by the shrinkage. This is not due to hydrocephalus.
Normal Pressure Hydrocephalus Prevention
There is no known way to prevent NPH. A healthy lifestyle, including not smoking, maintaining a healthy weight, and regular exercise, may help avoid conditions such as high blood pressure, heart disease, diabetes, and stroke that might contribute to NPH. Wearing a seatbelt and safety helmet when indicated can help avoid head injury, another cause of NPH.
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Watch For ‘water On The Brain’ In Older Adults
According to experts, one quarter million Americans with some of the same symptoms as dementia, Alzheimer’s or Parkinson’s may actually have normal pressure hydrocephalus . It’s often difficult to tell the difference because the symptoms of NPH are in many ways similar to those of Alzheimer’s or Parkinson’s. However, the feeling of feet glued to the floor or difficulty walking is the first symptom to appear in NPH. It’s different from, for example, Parkinson’s tremors. In Alzheimer’s, memory loss and confusion tend to be early symptoms, whereas in NPH these appear later. Fortunately, once NPH is confirmed, chances are it can be treated.
Sometimes referred to as “water on the brain,” NPH is a buildup of cerebrospinal fluid in the brain of older adults that leads to a gradual deterioration of motor skills and/or cognitive function. When diagnosed correctly, procedures to drain the excess CSF fluid can be performed and patients can often return to a normal life.
Elana Farace, a neuropsychologist and director of clinical research for Penn State Neurosurgery, evaluates patients who may be suffering from NPH at Penn State Milton S. Hershey Medical Center. She was recently invited to speak on the subject on “Retirement Living-Healthline,” a Comcast Network cable program seen in 12 eastern states.
“I didn’t think twice about it,” he recalled. “All I heard was that it would improve my condition, and I said ‘let’s go for it.’ “
Hydrocephalus Present From Birth
Congenital hydrocephalus is when a baby is born with excess fluid in their brain.
Many babies born with hydrocephalus have permanent brain damage.
This can cause several long-term complications, such as:
If your child has learning disabilities, they’ll need extra support from their nursery or school to ensure their needs are being met.
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What Causes Hydrocephalus In Children
Hydrocephalus is typically a symptom of some other problem, and a pediatric neurologist and neurosurgeon can to determine the cause. Sometimes hydrocephalus develops during pregnancy and in other cases, after birth.
Several conditions can result in blocked cerebrospinal fluid flow:
Inborn irregularities of the nervous system, such as
Why Does Cerebrospinal Fluid Come Out
If you suck it out, it will come out, like a leaky faucet. Spontaneous cerebrospinal fluid leaks occur when theres a loss of bone in the shelf of bone between the brain and the ear and a hole develops in the membrane bag that surrounds the brain, called the dura. Such leaks can also result from trauma.
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Normal Pressure Hydrocephalus Symptoms
Symptoms of normal pressure hydrocephalus may mimic other conditions such as Parkinson’s disease, Alzheimer’s disease and Creutzfeldt-Jakob disease. Signs and symptoms of this type of hydrocephalus can include progressive mental impairment and dementia, problems with walking and dysfunction of bladder control. People with normal pressure hydrocephalus may complain of slow body movements.
Treating Fluid On The Brain
The treatments for fluid on the brain will differ from person to person depending on the cause. The most common treatment is the surgical insertion of a shunt that allows the CSF to flow to a different area of the body and become absorbed by the circulatory system.
In very rare cases, doctors can use a small tool to make a hole in the ventricle so that the fluid can bypass whatever is causing the blockage. This treatment is not feasible for most people suffering from hydrocephalus.
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When Surgery Is Necessary
Hydrocephalus can be treated in a variety of ways. The problem area may be treated directly or indirectly . Indirect treatment is performed by implanting a device known as a shunt to divert the excess CSF away from the brain. The body cavity in which the CSF is diverted usually is the peritoneal cavity .
In some cases, two procedures are performed: one to divert the CSF and another at a later stage to remove the cause of obstruction . Once inserted, the shunt system usually remains in place for the duration of a patient’s life, although additional operations to revise the shunt system may be needed. The shunt system continuously performs its function of diverting the CSF away from the brain, thereby keeping the intracranial pressure within normal limits.
An alternative operation called endoscopic third ventriculostomy may be recommended. In this operation, a tiny burr hole is made in the skull and a neuroendoscope enters the brain. The neurosurgeon then will make a small hole in the floor of the third ventricle, creating a new pathway through which CSF can flow.
How Is Fluid Around The Lung Diagnosed
A physician will usually diagnosis pleural effusion based on interviewing the patient about symptoms and a physical examination. To confirm a diagnosis, he or she may also request an imaging test, which could be a chest X-ray, ultrasound, or computed tomography scan. To further help with diagnosis, a doctor may extract a sample of the excess fluid to be tested to determine the cause.
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What Is The Current Treatment For Hydrocephalus
Hydrocephalus is most often treated by surgically inserting a shunt system. This system diverts the flow of CSF from the CNS to another area of the body where it can be absorbed as part of the normal circulatory process.
A shunt is a flexible but sturdy plastic tube. A shunt system consists of the shunt, a catheter, and a valve. One end of the catheter is placed within a ventricle inside the brain or in the CSF outside the spinal cord. The other end of the catheter is commonly placed within the abdominal cavity, but may also be placed at other sites in the body such as a chamber of the heart or areas around the lung where the CSF can drain and be absorbed. A valve located along the catheter maintains one-way flow and regulates the rate of CSF flow.
A limited number of individuals can be treated with an alternative procedure called third ventriculostomy. In this procedure, a neuroendoscope a small camera that usesfiber optic technology to visualize small and difficult to reach surgical areas allows a doctor to view the ventricular surface. Once the scope is guided into position, a small tool makes a tiny hole in the floor of the third ventricle, which allows the CSF to bypass the obstruction and flow toward the site of resorption around the surface of the brain.
Types And Causes Of Hydrocephalus
Hydrocephalus is a complex, chronic condition. It can develop for a variety of reasons, sometimes as part of another condition. You can be born with it, acquire it from some brain tumors, infections of the brain, and brain injury. It may also develop it as part of the aging process.
In the United States, 1 in every 770 babies develops hydrocephalus. Hydrocephalus that is present at birth is referred to as congenital hydrocephalus. Hydrocephalus that develops later in life in some children, and even in adults, but is caused by a condition that existed at birth, is still considered a form of congenital hydrocephalus. Congenital hydrocephalus is caused by a complex interaction of genetic and environmental factors during fetal development. The most common causes of congenital hydrocephalus are:
- Spina bifida
For more detailed information, visit Types and Causes.
Normal pressure hydrocephalus occurs in older adults, typically diagnosed in individuals 60 and older. Normal pressure hydrocephalus is an accumulation of CSF that causes the ventricles in the brain to become enlarged, but there is little or no increase in the pressure within the ventricles. In most cases of NPH, the cause of blockage to the CSF absorptive pathways is unclear.
Primary NPH: Many NPH diagnoses are considered idiopathic, which means that the cause is unknown. These are also referred to as primary NPH.
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What Are The Signs And Symptoms Of Hydrocephalus
The signs and symptoms vary between individuals and can present differently based on age.
During pregnancy, a routine ultrasound may detect hydrocephalus in the baby.
In young babies, the skull bones are not yet fused together and there are soft spots, called fontanelles, between the bones. The most common sign of hydrocephalus in an infant is typically a large head or firm, bulging fontanelles.
Signs or symptoms of hydrocephalus in infancy may include:
- Bulging fontanelles
- A large head circumference or a rapid increase in head growth
- Swollen veins on the scalp
- Difficulty looking upward during eye movements
- Repetitive vomiting
- Excessive irritability, possibly due to head pain
- Very sleepy and difficult to awaken
Older children and adults will not have head growth with hydrocephalus and so they often display signs of increased head pressure. Headaches are the most common complaint. Signs or symptoms of hydrocephalus in older children and adults may include:
- Difficulty with motor skills or balance
- Blurry or double vision
- Difficulty looking upward during eye movements
If left untreated, hydrocephalus can cause developmental delays, personality changes and memory loss. In severe cases, untreated hydrocephalus may result in nerve damage, vision loss and even death. However, with prompt diagnosis and treatment, many infants and children with hydrocephalus are able to successfully manage their condition and lead long, healthy lives.
What Are The Causes Of Hydrocephalus
Acquired hydrocephalus is caused by damage to the brain after a head injury or after conditions such as stroke, brain haemorrhage , brain tumour, or meningitis . The damage results in enlarged ventricles which fill with excess CSF, or causes blockages at points where the CSF is absorbed into the bloodstream.
Normal pressure hydrocephalus
The cause of normal pressure hydrocephalus is usually unknown. It might be that the build-up of CSF is related to problems in the ventricles of the brain or an underlying health condition affecting the blood flow through the brain .
NPH usually affects people aged 50 years or older. The symptoms are similar to other conditions such as Alzheimers disease and, as a result, NPH might not always be diagnosed correctly.
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How Do You Relieve Pressure On The Brain
A decompressive craniectomy surgery is a procedure that removes a section of the skull to relieve pressure on the brain. It is an incision first made in the scalp, then through the bone using a special saw, which allows a piece of the skull to be removed and set aside to be replaced at a later date.
What Are The Symptoms Of Pleural Effusion
The symptoms of pleural effusion can range from none to shortness of breath to coughing, among others. The greater the build-up of fluid, the more likely symptoms will be noticeable. In addition to excess fluid, the tissue around the lung may become inflamed, which can cause chest pain. In extreme cases, a person can have up to four liters of excess fluid in the chest. It’s very uncomfortable. Imagine trying to breathe with two soda bottles pushed up against your lungs, Dr. Puchalski says.
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What Are The Chances A Pleural Effusion Will Happen Again
My patients always want to know if it will come back, says Dr. Puchalski. Sometimes it does and sometimes it doesnt. He explains that the risk of recurrence is based mostly on the cause of the pleural effusion in the first place. For lung cancer patients, he explains, the buildup is likely to occur again.
Normal Pressure Hydrocephalus Treatment And Home Care
Normal pressure hydrocephalus can sometimes be managed or possibly even reversed through surgery. For those who are not candidates for surgery, treatment consists of measures to relieve mood and behavioral problems, cope with physical problems such as incontinence and walking difficulties, and maximize physical, mental, and social functioning.
Surgery for normal pressure hydrocephalus
Normal pressure hydrocephalus is not caused by any structural abnormality, such as a brain tumor. In most cases, the underlying problem is not known or cannot be treated. The treatment in these cases is a shunt operation.
A shunt is a thin tube that is implanted in the brain by a neurosurgeon. It is inserted into the ventricles to drain excess CSF away from the brain. The tube is routed under the skin from the head to another part of the body, usually the peritoneum . The shunt is equipped with a valve that opens to release fluid when the pressure builds up. The fluid drains harmlessly and is later absorbed by the bloodstream. The pressure setting on the valve sometimes must be readjusted. The newer shunts allow adjustment without another operation.
A shunt operation is not a cure. It does not treat the underlying cause of NPH. It can, however, relieve the symptoms. The shunt remains in place indefinitely. If properly implanted, the shunt often is not obvious to other people.
Caring for someone with normal pressure hydrocephalus
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