Description
Mostly, as a result of blockage of the cerebrospinal fluid flow path, a clinical picture called hydrocephalus occurs in cases where there is excessive fluid increase in the brain. This excessive increase in fluid causes damage to the surrounding brain tissue by compressing it. It can be fatal if left untreated. Symptoms of the disease vary according to age.
Signs of hydrocephalus in newborns:
An unusual head size
A sudden increase in head circumference
swelling of the fontanel
Vomiting
Prone to sleepiness
Irritability
Seizures
‘setting sun’ in the eyes
Developmental delay
Most common symptoms in older children and adolescents:
Headache following vomiting
Nausea
Blurred or double vision
‘Setting sun view’ in the eyes
Coordination, balance and gait disturbances
Exhausted look
Slowing down or regression in development
Memory loss
Confusion
Urinary incontinence
Personal Physical changes
Failure in classes or working life, decline in intelligence level
Hydrocephalus can be seen with different symptoms and signs mentioned above, depending on the underlying cause and age. For example, in a condition called normal pressure hydrocephalus, which is mostly seen in the elderly population, the disease typically starts with walking difficulties. Then, urinary incontinence is seen and dementia develops in the last period.
In which cases should a doctor be consulted?
Infants and toddlers
High-pitched crying
Trouble sucking and feeding
Unexpected , frequent vomiting
Unwillingness to move the head and neck
Respiratory problems
In case of symptoms such as seizure, the patient should be treated immediately.
Increase in head circumference
Outward swelling of the fontanelle
Observation of changes in the appearance of the face and eyes
In case of findings such as decreased interest in the environment and regression in social relations, emergency Although not, it is necessary to consult a pediatrician in elective conditions.
Adult person
Difficulty walking
Impaired thinking ability
In case of symptoms such as urinary incontinence, the patient should be examined physically and neurologically in a full-fledged center.
In cases where there is excessive fluid increase in the brain, a clinical picture called hydrocephalus occurs.
Our brain is a gelatinous tissue, almost floating in the cerebrospinal fluid. This fluid also fills the spaces called ventricles located deep in the brain. Thus, the brain is not affected by concussion and floats unsinkably in the cerebrospinal fluid.
Cerebrospinal fluid circulates through the ventricles through interconnecting channels.
The delicate balance between the production, flow and absorption process of the cerebrospinal fluid is very important for the fluid to circulate in the head under normal pressure. The clinical picture called hydrocephalus occurs when this delicate balance is disturbed. For example, disruption in any step in the fluid circulation process, such as narrowing of the channels that provide the passage between the ventricles or a damage in the absorption of fluid, causes the formation of hydrocephalus.
Defect in absorption of cerebrospinal fluid causes normal pressure hydrocephalus, mostly seen in the elderly population. In normal pressure hydrocephalus, excess fluid causes enlargement of the ventricles, but does not cause an increase in pressure on the brain tissue. Although this clinical picture may occur due to any injury or other disease, in most cases no cause can be found.
EXAMINATION AND DIAGNOSIS
In infants and children;
*Prenatal ultrasound during pregnancy
*Measurement of head circumference during routine follow-ups during infancy and early childhood
In older children and adults;
If your doctor suspects hydrocephalus when he evaluates the symptoms and signs, he should learn the course of the disease in detail, perform a detailed physical and neurological examination, and perform imaging with CT or MRI before making the diagnosis. If hydrocephalus is diagnosed as a result of the examinations, the patient should be referred to a neurosurgeon for further examination and treatment.
Treatment of hydrocephalus is usually surgical.
Surgical methods:
Shunt implantation. It is the most common treatment method in hydrocephalus. A drainage system called a shunt is surgically placed. This system, which has a flexible valve structure in the form of a long, thin tube; It ensures the flow of fluid from the brain in the right direction, at the right rate and amount. One end of the shunt is placed in the ventricle of the brain. After creating a tunnel under the skin over the fascia, the drainage system is placed in a body cavity such as the abdominal cavity, the heart, where the fluid from the brain can be absorbed.
Following the shunt placement in a child with hydrocephalus, he may need additional surgeries such as lengthening the shunt due to the growth of the patient or revision due to the development of infection.
Ventriculostomy. With this surgical method, in the period when there is an obstruction in the interventricular cerebrospinal fluid flow, the flow of fluid towards the base of the brain is ensured through a hole opened in the lower part of the ventricle.
If your child has hydrocephalus, it can be recommended to be included in a treatment program including a pediatric psychologist, education specialist, rehabilitation specialist, and to be successful in daily and school life. These specialists evaluate your child’s development and detect delays in social, emotional, mental and physical development, making it possible for your child to reach their maximum potential with timely interventions.
