Hydrocephalus is known as excessive accumulation of water in the brain, often in children and the elderly. The water referred to here is “cerebrospinal fluid”. This fluid reduces the harmful effects of blows to the brain and spinal cord, helps to nourish the brain and transport wastes as it is continuously made and reabsorbed throughout the day, and regulates the pressure changes in the brain by circulating between the brain and spinal cord. Excessive accumulation of this fluid may be due to intracerebral hemorrhages, head traumas, brain tumors, hemorrhages due to premature birth and meningitis; It may be hereditary or due to meningocele-like developmental disorders, and may even be seen in the elderly after reduced reabsorption of cerebrospinal fluid.
Diagnosis of Hydrocephalus:
Today, most of the children are diagnosed with hydrocephalus at birth or before birth. In the first two months after birth, signs such as head growth more than normal, thinning of the scalp, prominent veins in the head, vomiting, restlessness, drooping eyes, seizures or inability to communicate; Two months later, symptoms such as abnormal growth of the head, headache, nausea, vomiting, fever, double vision, restlessness, regression in walking or speaking, communication disorder, loss of sensory-motor functions, seizures, and difficulty in staying awake or waking up in older children may be seen. Middle-aged adults headache, difficulty waking or staying awake, balance disorder, urinary incontinence, personality disorder, dementia, visual impairment; In the elderly, symptoms such as impaired communication, gait instability, difficulty in remembering, headache, and urinary incontinence may be at the forefront. Brain Tomography (CT), Magnetic Resonance Imaging (MR), Brain Ultrasonography may be requested from the patients.
Hydrocephalus Treatment:
Hydrocephalus can be treated only with surgical interventions to be performed by neurosurgeons, thus preventing the increase in pressure in the brain. If there is an obstruction that causes the circulation of the cerebrospinal fluid to be impaired, hydrocephalus surgery can be performed for the cause of the obstruction (such as tumor, cyst). In a selected group of patients, the correction of fluid circulation can also be performed by endoscopic surgery. In the majority of patients, the fluid is transferred from the brain to another body cavity with a thin, long, elastic, silicone tube called a “shunt” placed under the skin. There is another part of this tubing system called the “pump” under the scalp so that the fluid flow can be unidirectional and at a controlled speed. The most commonly used method in babies diagnosed while in the womb; the baby is delivered as early as possible and the operation is performed.
Short-term antibiotics are used to prevent postoperative infection, and the patient is observed in the hospital for a while after surgery. If permanent damage has occurred in the brain tissue, some functions of the patient may not improve. These patients need long-term follow-up to monitor whether the shunt is working, because it needs urgent replacement in case of shunt failure and infection.
The shunt does not need a power source such as a battery. If a shunt that can be pressure adjusted from the outside and affected by magnetic field is inserted, the patient should consult his doctor before performing a magnetic resonance (MR) examination. Pressing the pump excessively with a finger will cause it to malfunction and it is not appropriate to lay the baby on the side of the shunt during infancy. In most patients, the need for a shunt will continue for life. If; redness and tenderness at the surgical site and over the shunt line; If the patient has complaints such as restlessness, nausea, vomiting, headache, double vision, fever, abdominal pain, and convulsions, the patient should be consulted immediately because shunt-related problems can develop very quickly, sometimes even within hours.
