Hydrocephalus is a neurological pathology in adults or children. Acute, chronic or at normal pressure, it is caused by the increase in the volume of cerebrospinal fluid in the brain. What are the symptoms ? What treatments? The operation? What is the life expectancy for patients?
Hydrocephalus is manifested by a too much cerebrospinal fluid in the brain. In adults, acute, chronic and normal pressure hydrocephalus are distinguished. From symptoms, it causes headaches, nausea and vomiting. What are the risks ? What treatments to treat hydrocephalus? The operation is it necessary? Which is life expectancy patients with hydrocephalus?
Definition: what is hydrocephalus?
L’hydrocephalus means the presence of too much cerebrospinal fluid in the cavities of the brain called ventricles. There are several types of hydrocephalus:
► Acute hydrocephalus. It can be brutal, then called acute hydrocephalus and often linked to subarachnoid hemorrhage. A caillot de sang in this case blocks the normal outflow of cerebrospinal fluid contained in the ventricles, resulting in a rapid accumulation.
► Chronic hydrocephalus. It is a form of hydrocephalus where an amount of fluid remains in the brain. Stagnation caused by a malfunction in the evacuation of the liquid.
► Normal pressure hydrocephalus. It is a form of chronic hydrocephalus in adults linked to the partial obstruction of the cerebrospinal fluid circulation channels. The symptoms are balance disorders and walking, urinary and sometimes rectal incontinence and cognitive disorders with impairment of intellectual faculties.
What is the cause of hydrocephalus?
In the majority of cases, hydrocephalus results from a obstruction of fluid circulation around the brain or a decrease in resorption of fluid in the veins.
What are the symptoms of hydrocephalus?
A acute or chronic hydrocephalus, causes the dilation of the cavities located in the brain. The cranial box being inextensible, it can result in a compression of the tissues located in the skull and of the neurological consequences. The syndromeintracranial hypertension is the clinical consequence. Then appear:
- of the headache increased when coughing and when lying down,
- of the nausea,
- of the vomiting,
- a vision double.
The signs of a normal pressure hydrocephalus in adults include:
- and balance and walking disorder,
- of the mental disorders, gradually leading to a dementia,
- a urinary and fecal incontinence.
In case of clinical suspicion, hydrocephalus will be detected through a brain imaging, CT or IRM, become the reference examination for this type of pathology. This examination can reveal the dilation of the cerebral ventricles.
in case normal pressure hydrocephalus, a lumbar puncture by a sting in the back removes cerebrospinal fluid from the space surrounding the spinal cord. This may have the effect of improving symptoms. The punctures can be repeated or the establishment of an internal ventricular shunt to evacuate excess fluid chronically is possible. Treatment for acute hydrocephalus is neurosurgical. The surgeon will perform an emergency external ventricular bypass.
What are the risks of hydrocephalus?
Hydrocephalus can lead to intracranial hypertension with compression of certain brain structures that can cause irreversible brain damage. This is an emergency requiring surgical management to divert the flow of excess fluid. Hydrocephalus can also be slower to build: this is called normal pressure hydrocephalus.
Hydrocephalus requires regular medical monitoring throughout the patient’s life
How effective are treatments for hydrocephalus?
“Surgical management of normal pressure hydrocephalus provides good results on motor and sphincter disorders. If caught early, results are also good on cognitive disorders“, details Dr. Renaud Bougeard, neurosurgeon. And to add: “in regards to acute hydrocephalus, the result will depend on the time it takes to take care of before irreversible brain damage is formed“.
What is the life expectancy of people with hydrocephalus?
Hydrocephalus is considered a chronic disease that requires regular medical monitoring throughout life, in a neurosurgery department. Depending on the time taken for management and the follow-up of the treatments, the life expectancy of the patients is not reduced.
Thanks to Dr. Renaud Bougeard, neurosurgeon.
