MedClinic > Blog > Neurosurgery > Hydrocephalus

 

Brain hydrocephalus in an adult and a child is an excessive accumulation of cerebrospinal fluid associated with increased cerebrospinal fluid production and/or cerebrospinal fluid outflow. This disease is dangerous for its consequences for the work of the whole organism.

Classification

By origin:

  • Congenital
  • Acquired

By the mechanism of development:

  • Obstructive (non-communicating) – cerebrospinal fluid flow is disrupted due to obstruction of the pathways by a tumor, hematoma or post-inflammatory process.
  • Communicating (open) – cerebrospinal fluid absorption processes are disrupted.
  • Hypersecretory – excess cerebrospinal fluid production.

By pace:

  • Acute – up to 3 days.
  • Subacute – develops within a month from the moment of illness initiation.
  • Chronic – from 3 weeks to 6 months or more.

By the level of cerebrospinal fluid pressure:

  • Hypertensive.
  • Normotensive.
  • Hypotensive.

Provocative factors

Brain hydrocephalus occurs for the following reasons:

  • head injuries;
  • birth injuries;
  • age-related changes.

Symptoms&Signs

The sooner you start treatment for hydrocephalus, the more chances there are to prevent the development of severe complications. Signs of hydrocephalus include:

  • headache (most intensive in the morning)
  • nausea, vomiting;
  • sleep disturbance;
  • tearfulness;
  • twitching and convulsions;
  • severe pain in the head accompanied by vomiting;
  • inability to focus;
  • downward displacement of the eyeball;
  • general weakness, apathy;
  • memory impairment;
  • personality changes.

The leading role in the diagnosis of hydrocephalus is played by:

  • CT
  • MRI

How to treat it?

Treatment methods are selected individually. Hydrocephalus in the initial stages of development is treated with medications. Conservative therapy only helps to cope with the symptoms of the disease and ease the person’s physical condition, but medications are not able to remove the causes of the disease. In the absence of a positive result from taking medication, surgical treatment of hydrocephalus is prescribed.

One method of surgical treatment for hydrocephalus is bypass surgery. The essence of bypass surgery is that special valves and tubes are installed to help to constantly maintain the process of cerebrospinal fluid circulation at the required level. One disadvantage of the operation is that the tubes used for the outflow of fluid can clog over time, and the patient will have to undergo an emergency reoperation.

The prognosis after bypass surgery is favorable, the patient can lead a full-fledged lifestyle, but he/she will forever depend on how correctly and harmoniously the valves work and the tubes function.

Can hydrocephalus be treated without the risk of relapse? Yes, but only using endoscopy. Unfortunately, this method of treating pathology is very expensive and requires a highly qualified and experienced neurosurgeon.

The essence of this surgical intervention is that with the help of special tools an artificial channel is created in the brain for the outflow of cerebrospinal fluid, which flows out of the brain along this duct. No additional operations will be required.

The advantage of this type of surgical treatment of hydrocephalus is that the process of physiological outflow and circulation of cerebrospinal fluid will be restored forever. During endoscopy, no foreign bodies are implanted into the patient’s body (as in shunting), which means that there is no risk of developing side effects associated with the process of biological adaptation of the body to an object foreign to it.

Treatment of congenital hydrocephalus implies, first of all, the relief of the main cause of the disease. If the pathology has arisen due to the presence of volumetric processes in the brain, they are removed by surgical intervention, in particular, hematomas, tumors, abscesses and adhesions on the soft tissues of the organ are removed.