What Is Hydrocephalus
What Is Hydrocephalus
What Is Hydrocephalus
The term hydrocephalus is derived from the Greek words "hydro" meaning
water and "cephalus" meaning head. As the name implies, it is a condition in
which the primary characteristic is excessive accumulation of fluid in the brain.
Although hydrocephalus was once known as "water on the brain," the "water"
is actually cerebrospinal fluid (CSF) a clear fluid that surrounds the brain
and spinal cord. The excessive accumulation of CSF results in an abnormal
widening of spaces in the brain called ventricles. This widening creates
potentially harmful pressure on the tissues of the brain.
CSF has three important life-sustaining functions: 1) to keep the brain tissue
buoyant, acting as a cushion or "shock absorber"; 2) to act as the vehicle for
delivering nutrients to the brain and removing waste; and 3) to flow between
the cranium and spine and compensate for changes in intracranial blood
volume (the amount of blood within the brain).
The number of people who develop hydrocephalus or who are currently living
with it is difficult to establish since there is no national registry or database of
people with the condition. However, experts estimate that hydrocephalus
affects approximately 1 in every 500 children.
Older children and adults may experience different symptoms because their
skulls cannot expand to accommodate the buildup of CSF. Symptoms may
include headache followed by vomiting, nausea, papilledema (swelling of the
optic disk which is part of the optic nerve), blurred or double vision, sunsetting
of the eyes, problems with balance, poor coordination, gait disturbance,
urinary incontinence, slowing or loss of developmental progress, lethargy,
drowsiness, irritability, or other changes in personality or cognition including
memory loss.
The symptoms described in this section account for the most typical ways in
which progressive hydrocephalus manifests itself, but it is important to
remember that symptoms vary significantly from one person to the next.
A shunt is a flexible but sturdy plastic tube. A shunt system consists of the
shunt, a catheter, and a valve. One end of the catheter is placed within a
ventricle inside the brain or in the CSF outside the spinal cord. The other end
of the catheter is commonly placed within the abdominal cavity, but may also
be placed at other sites in the body such as a chamber of the heart or areas
around the lung where the CSF can drain and be absorbed. A valve located
along the catheter maintains one-way flow and regulates the rate of CSF flow.
A limited number of individuals can be treated with an alternative procedure
called third ventriculostomy. In this procedure, a neuroendoscope a small
camera that uses fiber optic technology to visualize small and difficult to reach
surgical areas allows a doctor to view the ventricular surface. Once the
scope is guided into position, a small tool makes a tiny hole in the floor of the
third ventricle, which allows the CSF to bypass the obstruction and flow toward
the site of resorption around the surface of the brain.
Shunt systems are not perfect devices. Complications may include mechanical
failure, infections, obstructions, and the need to lengthen or replace the
catheter. Generally, shunt systems require monitoring and regular medical
follow up. When complications occur, the shunt system usually requires
some type of revision.
The National Institute of Neurological Disorders and Stroke (NINDS) and other
institutes of the National Institutes of Health (NIH) conduct research related to
hydrocephalus in laboratories and clinics at the NIH and support additional
research through grants to major medical institutions across the
country. Much of this research focuses on finding better ways to prevent,
treat, and ultimately cure disorders such as hydrocephalus. The NINDS also
conducts and supports a wide range of fundamental studies that explore the
complex mechanisms of normal and abnormal brain development.