- 26 Jul, 2023
- Dr. Arun Rajeswaran
- No comment
What Are The Symptoms Of Hydrocephalus?
Introduction to Hydrocephalus
Hydrocephalus is a neurological disease that happens when cerebrospinal fluid builds up in the brain in a way that shouldn’t happen. This buildup of fluid can exert pressure on the brain, potentially leading to severe complications. Recognizing the symptoms of hydrocephalus is vital to ensure early diagnosis and appropriate treatment.
Common Symptoms of Hydrocephalus
Headache and vomiting:
Frequent and severe headaches are one of the common early symptoms of hydrocephalus. Nausea and vomiting may also accompany the headaches.
Blurred or double vision:
Hydrocephalus symptoms can affect the optic nerve, leading to visual disturbances like blurred or double vision.
Changes in behavior and personality:
People with hydrocephalus symptoms may experience mood swings, irritability, and alterations in their usual behavior.
Difficulty in walking or poor coordination:
Gait disturbances, imbalance, and clumsiness are typical signs of hydrocephalus, particularly in older individuals.
Cognitive decline and memory issues:
The symptoms of hydrocephalus can cause problems with memory, concentration, and overall cognitive functioning.
Symptoms of Hydrocephalus in Specific Groups
Symptoms in infants and children:
In babies, hydrocephalus may lead to a rapid increase in head size, vomiting, sleepiness, and seizures. Older children might exhibit irritability, poor academic performance, and delayed development.
Symptoms in adults:
Adults with hydrocephalus may experience cognitive decline, urinary incontinence, and difficulty in walking.
Symptoms in elderly individuals:
Hydrocephalus in older adults can manifest as gait disturbances, memory loss, and impaired bladder control.
Types of Hydrocephalus and Their Distinctive Symptoms
Communicating hydrocephalus:
In this type, the cerebrospinal fluid flows freely but gets absorbed too slowly, leading to increased pressure. Symptoms may vary depending on the underlying cause.
Non-communicating hydrocephalus:
Blockages obstruct the flow of cerebrospinal fluid in this type, causing a buildup and pressure.
Normal pressure hydrocephalus (NPH):
NPH typically affects older adults and may present with normal pressure hydrocephalus symptoms similar to other types of hydrocephalus. However, the characteristic feature is that cerebrospinal fluid accumulates without an increase in pressure.
Diagnosing Hydrocephalus
Here are a few ways which neurosurgeons use while diagnosing hydrocephalus:
Medical history and physical examination:
A thorough assessment of the patient’s medical history and a neurological examination are crucial initial steps.
Imaging tests (CT scan, MRI):
Computed tomography (CT) scan or magnetic resonance imaging (MRI) can provide detailed images of the brain, aiding in the diagnosis.
Lumbar puncture (spinal tap):
A lumbar puncture involves extracting cerebrospinal fluid through a needle inserted into the lower back for further analysis.
Treatment Options
Shunt placement surgery:
A shunt is a medical device that helps drain excess cerebrospinal fluid from the brain to another part of the body.
Endoscopic third ventriculostomy (ETV):
ETV is a minimally invasive procedure where a small hole is made in the floor of the third ventricle to allow cerebrospinal fluid to flow freely.
Third ventriculostomy with choroid plexus coagulation (TVC):
TVC involves cauterizing a portion of the choroid plexus to reduce cerebrospinal fluid production.
Prevention and Conclusion
Hydrocephalus can have a significant impact on a person’s quality of life if left untreated. While certain cases of hydrocephalus cannot be prevented, early diagnosis and appropriate treatment can minimize complications. If you or someone you know experiences any of the symptoms of hydrocephalus mentioned earlier, seek immediate medical attention to ensure timely intervention and better outcomes. Remember, recognizing the hydrocephalus symptoms early can make all the difference.
Frequently Asked Questions
In infants, the skull sutures are not yet fused, so the head can expand to accommodate excess CSF. Key signs include a rapidly increasing head circumference (crossing percentile lines on growth charts), a bulging anterior fontanelle, prominent scalp veins, irritability, poor feeding, downward eye deviation (‘sunsetting’ sign), and high-pitched crying. In adults and older children, where the skull is rigid, hydrocephalus presents with the symptoms of raised intracranial pressure: severe headache (typically worse in the morning or when lying down), nausea, vomiting, blurred vision, and progressive cognitive decline.
Normal Pressure Hydrocephalus (NPH) is a form of hydrocephalus that occurs predominantly in adults over 60 years of age. Despite enlarged ventricles on imaging, cerebrospinal fluid (CSF) pressure is within the normal range at lumbar puncture. It presents with a characteristic clinical triad: gait disturbance (described as ‘magnetic gait’ wide-based, shuffling steps as if feet are stuck to the floor), urinary incontinence, and cognitive decline (dementia-like symptoms). This triad is often misdiagnosed as Parkinson’s disease or Alzheimer’s dementia. NPH is one of the few potentially reversible causes of dementia.
Acute hydrocephalus can be rapidly life-threatening if CSF pressure rises to levels that compress the brainstem. Emergency signs include sudden severe headache, projectile vomiting, rapidly decreasing level of consciousness, visual disturbance, seizures, and loss of upward gaze. These constitute a neurological emergency requiring immediate hospital transfer for urgent CT brain imaging and emergency CSF drainage (external ventricular drain) or surgery. Patients with known shunts who develop new or worsening symptoms should be assessed urgently for shunt malfunction.
