Hydrocephalus: definition, causes, symptoms, treatment, etc.

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Definition

What is hydrocephalus?

Source: Mom Junction

Hydrocephalus is a condition characterized by the size of a baby's head that is abnormally enlarged.

Quoting from the American Association of Neurological Surgeons, this condition can occur due to a buildup of fluid in the ventricular cavity of the brain.

So, it can be said that hydrocephalus is a buildup of cerebrospinal fluid in the brain cavity (ventricles), causing the brain to swell.

Normally, this cerebrospinal fluid will flow through the brain and spinal cord and then be absorbed by the blood vessels.

Unfortunately, too much pressure on the cerebrospinal fluid can damage brain tissue, causing various problems related to brain function.

Almost all parts of the child's body will be affected by hydrocephalus, from growth disorders to decreased intelligence.

If not treated immediately, this can cause brain damage and other health problems in sufferers, especially children.

Although it is more common in infants and children, hydrocephalus can also occur in adults.

How common is this condition?

Hydrocephalus is a congenital defect commonly experienced by babies which can be caused by various supporting factors.

The presence of infection in the uterus during pregnancy can cause inflammation of the fetal brain tissue.

In addition, central nervous system infections and lesions or tumors in the brain and spinal cord in babies can also cause meningitis.

Although mostly experienced by babies, hydrocephalus is a condition that can be experienced at any age.

Apart from babies, this condition is also experienced by many adults over 60 years of age.

However, don't worry, you can reduce the risk of the baby developing this disease by reducing the risk factors it has.

Consult your doctor for more information.

Signs and symptoms

What are the signs and symptoms of hydrocephalus?

Hydrocephalus can result in permanent damage to a child's brain and head cavity.

That is why it is important to recognize the signs and symptoms that might occur if your child has this condition so they can seek medical help as soon as possible.

Symptoms of hydrocephalus in newborns

You probably already know that the most common symptom of hydrocephalus in children is an enlarged head from a normal size.

However, the symptoms of this condition in children tend to vary, depending on their age.

Various hydrocephalus symptoms in newborns or children less than one year old, namely:

• An abnormally soft lump appears on the top of the head (fontanelle)
• Rapid change in head circumference
• The size of the head circumference is very large more than it should be
• A prominent, highly visible point of a soft bulge (fontanelle) on top of the head
• A thin, shiny scalp with easily visible venous blood flow
• Abnormal head size
• Eyes down
• Easy to fuss
• Refusing to eat
• Easily sleepy
• Weakened muscles
• Stunted growth
• Do not want to eat or decreased appetite
• The baby vomits
• Easily sleepy
• Body spasms
• Decreased muscle strength or a weakened baby's body
• Babies cry, are fussy, or get angry easily
• Body growth is not going well

Symptoms of hydrocephalus in children

Hydrocephalus can also be experienced by children aged 1 to 5 years, aka pre-school age.

Besides being marked by an enlargement of the head size,hydrocephalus symptoms in children ages 1 to 5 years that need to be aware of include:

• Headache
• Cryed for a while but his voice rose
• Cockeye
• Blurred vision or crossed eyes
• Changes in facial structure
• Stunted growth
• Easily sleepy
• It's hard to eat
• Unstable body balance
• Loss of muscle coordination
• Easy to get angry
• Impaired cognitive abilities
• Muscle spasms
• Nausea and vomiting
• Difficulty concentrating

Behavioral and cognitive changes in infants and children

Some of the behavioral and cognitive changes that occur as symptoms of hydrocephalus in infants and children are as follows:

• Difficulty concentrating
• Irritable and cranky
• Personality changes
• Decreased ability at school
• Experiencing delays or problems with abilities that have been able to do before, such as learning to walk and speak

Symptoms of hydrocephalus in adults

In addition to infants and children, symptoms of hydrocephalus can also be experienced by adults.

The following are symptoms of hydrocephalus in adults:

• Often falls suddenly
• Severe headache
• Nausea
• It's hard to walk
• Impaired eyesight
• It's hard to remember what happened
• Difficulty concentrating
• Bladder problems
• Seizures

When to see a doctor?

If you see your little one has any of the above signs or other questions, consult your doctor. The health condition of each person's body is different.

Always consult a doctor in order to get the best treatment regarding your and baby's health condition.

Based on the Mayo Clinic, the following signs and symptoms suggest that you should immediately see your little one to the doctor:

• Often screams in a high tone
• Having problems with sucking and breastfeeding
• Vomiting repeatedly
• It is difficult to lie down and move your head
• Difficulty breathing smoothly
• Body convulsions

The appearance of one or more of these signs should not be taken lightly because of the risk of leading to hydrocephalus.

Therefore, it is important to get a proper and prompt diagnosis and treatment.

Cause

What causes hydrocephalus?

The brain normally contains clear fluid that is produced in the ventricular cavity. This fluid is called cerebrospinal fluid.

Cerebrospinal fluid should flow from the spinal cord to the rest of the brain to support various brain functions.

The function of normal amounts of cerebrospinal fluid is as follows:

• Keeps the brain fresh.
• Protect and prevent injury to the brain.
• Removes the waste products of metabolism in the brain.
• Flows along the cavity of the brain and spine to maintain pressure in the brain.

However, when the amount of cerebrospinal fluid is excessive, it will actually result in permanent damage to brain tissue which causes disruption in the physical and intellectual development of the child.

An increase in the size of the head occurs because the amount of excess cerebrospinal fluid is produced so that it presses on the skull.

This condition also occurs because the cerebrospinal fluid cannot flow properly in the brain.

Most cases of hydrocephalus in children occur from birth (congenital birth defects / congenital abnormalities).

Under certain conditions, the cerebrospinal fluid in the brain can increase for various reasons, including:

• Blockage in the brain or spinal cord.
• Blood vessels are unable to absorb cerebrospinal fluid.
• The brain produces so much cerebrospinal fluid that it is not able to be fully absorbed by the blood vessels.

What are the types of hydrocephalus?

Based on the condition of structural defects and the amount of cerebrospinal fluid in the brain, hydrocephalus can be divided into several types such as:

1. Acquired hyrocephalus

This hydrocephalus is a type that develops after birth or during adulthood.

This hydrocephalus is usually caused by an injury or disease.

2. Congenital hydrocephalus (congenital hydrocephalus)

Congenital hydrocephalus is commonly experienced when a newborn is born.

This type of hydrocephalus can be caused by a condition that previously took place during fetal development or as a result of a genetic disorder.

3. Communicating hydrocephalus

This type of hydrocephalus occurs when there is no obstruction to the excess flow of cerebrospinal fluid in the ventricular system.

The cause of this type of hydrocephalus is due to the amount of cerebrospinal fluid that is too much outside of normal.

4. Non-communication (obstructive) hydrocephalus

This type of hydrocephalus occurs when the flow of cerebrospinal fluid becomes blocked in one or more of the ventricles of the brain.

This condition over time causes the flow of fluid to expand, causing pressure in the brain to increase.

5. Normal pressure hydrocephalus (normal pressure hydrocephalus)

Normal pressure hydrocephalus is a type of hydrocephalus that can be experienced by any age.

Even so, this type of hydrocephalus is more common in old age.

The most characteristic feature of this type of normal pressure hydrocephalus is the dilation of the ventricles with normal pressure inside the spine.

6. Hydrocephalus ex-vacuo

This type of hydrocephalus is most commonly experienced by adults who already have degenerative diseases.

This degenerative disease, for example, Alzheimer's and stroke.

This condition can cause damage to the brain, causing brain tissue to shrink.

Risk Factors

What increases the risk of developing this condition?

In fact, it is not certain what causes hydrocephalus other than an increase in excess cerebrospinal fluid.

However, several medical problems as well as developmental disorders in the baby can contribute as risk factors for this condition.

Risk factors for hydrocephalus in newborns

There are several conditions that increase the chances of developing hydrocephalus in newborns, such as:

• The central nervous system does not develop normally, thus blocking the flow of cerebrospinal fluid.
• There is bleeding in the ventricles of the brain, which triggers the possibility of premature birth.
• The mother has an infection that attacks the uterus during her pregnancy, causing inflammation in the fetal brain tissue.

Infections in the uterus that cause inflammation of the fetal brain tissue include rubella, toxoplasma, goiter and chickenpox infections.

Other supporting risk factors

In cases of hydrocephalus that occur only after the child grows up, risk factors include injury to the head that affects the brain, or:

• Tumors in the brain or spinal cord
• Infection of the brain or spinal cord
• Bleeding in the blood vessels of the brain
• Head surgery
• Severe head injury

If a child has several factors that increase the risk of hydrocephalus, regularly consult a doctor.

Complications

Are there any complications or long-term effects from hydrocephalus?

Complications or long-term effects arising from this condition vary widely and depend on several factors.

The determinants of the severity of complications from hydrocephalus include the underlying medical problem, the severity of early symptoms, and the speed with which they are diagnosed and treated.

If this condition has started to develop since the baby was born, it can cause problems with the baby's brain and physical development.

Conversely, if this condition is not so severe and can be treated as soon as possible, the chances of complications will be much smaller and mild.

Babies with congenital hydrocephalus can experience permanent brain damage, which can lead to long-term complications.

Here are some complications in babies with congenital hydrocephalus:

• The baby's attention is limited
• Autism
• Difficulty in learning
• Having problems with physical coordination
• Having trouble speaking
• Experiencing vision problems

If left unchecked, these complications can inhibit the baby's growth and development.

Diagnosis and Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the usual tests to diagnose hydrocephalus?

Examination related to hydrocephalus is usually determined from general physical condition, neurological or neurological, and brain imaging tests.

The nervous system or neurological examination is determined based on the person's age.

The doctor will usually ask your little one to do simple tests to assess the condition of the muscles, movement and sensory function of the body.

While the brain imaging examination is as follows:

Ultrasound

Ultrasound or ultrasound is an examination involving high-frequency sound waves. Ultrasound to check hydrocephalus in babies can be done since the baby is still in the womb.

Magnetic resonance imaging (MRI)

MRI is an examination that uses radio waves and a magnetic field. This test aims to produce a more detailed image of the brain's condition.

MRI can also be used to find out the cause of hydrocephalus or other medical conditions that are contributing to the symptoms.

CT scan

Computerized tomography (CT) scan is an examination with the help of X-rays to provide an overview of the condition of the brain.

However, CT scans to diagnose hydrocephalus are usually only used in an emergency.

What are the treatment options for hydrocephalus?

It is important to understand the symptoms of this condition in children as early as possible. The sooner you find the symptoms, the sooner your child will get proper treatment from a doctor.

There are two treatments that are usually used as a treatment for cases of hydrocephalus in children, namely:

1. The shunt system

A shunt system is a surgical procedure that places a catheter (tube with a valve) inside the brain.

The catheter aims to remove excess cerebrospinal fluid from the brain to other parts of the body such as the stomach, chest cavity and heart chambers.

Other parts of the body that are used as a place to drain excess cerebrospinal fluid from the brain, usually in the peritoneal cavity (the area around the abdominal organs) and the space in the heart.

This is because both parts of the body are considered easy and fast in absorbing excess cerebrospinal fluid from the brain.

Interestingly, in the shunt there is a special valve that controls the flow of cerebrospinal fluid.

That way, the excess cerebrospinal fluid flowing from the brain to other parts of the body will not be too fast.

This hydrocephalus handling procedure generally needs to be done for life.

In other words, children with this shunt procedure must regularly carry out monitoring to check the condition of the catheter from the brain to other parts of the body.

This hydrocephalus treatment procedure will help keep the cerebrospinal fluid in the baby's brain within normal limits.

2. Ventriculostomy

Ventriculostomy is a surgical procedure that involves using a small video camera to see inside the brain.

The doctor will then make a hole in the bottom of one of the ventricles of the brain or between the ventricles.

This aims to make it easier for cerebrospinal fluid to flow from the brain.

After the excess cerebrospinal fluid has been removed by making a hole, then the endoscope or small camera is taken back.

Next, the doctor closes the wound or hole in the brain and head by making stitches.

Cerebrospinal fluid will then flow outward through the opening to reduce blockage.

Prevention

Is there any way to prevent hydrocephalus?

Hydrocephalus in children is not really a preventable condition. However, you can breathe a little easier because at least there are still ways to reduce the risk of this disease.

If you are or are planning to become pregnant, always make sure to get the right care during pregnancy, for example by routine pregnancy checks.

This method can help you to detect any abnormalities in the fetus.

Not only that, routine pregnancy checks also help reduce the possibility of a baby being born prematurely, which can be a risk factor for or a complication of this condition.

Have your uterus checked regularly and make sure you receive immunizations while pregnant.

This is useful for dealing with various infections that may occur during pregnancy and preventing the risk of premature birth, a risk factor for hydrocephalus.

Meanwhile in children, protect your little one's head from the various collisions that can occur.

Take, for example, wearing a helmet when a child is cycling or pairing it car seat to prevent collisions when in the car.

Simple steps like this are expected to have a big impact in reducing the risk of this condition in children.