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What is Hydrocephalus by Jacqueline Rohrer

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Hydrocephalus is the buildup of excess cerebral fluid in the skull. The word hydrocephalus originates from two Greek words, “hydro-” meaning water and “cephalus” meaning head, thus this disease is commonly referred to as “water on the brain”. Typically, cerebral fluid circulates through ventricles in the brain. In the case of hydrocephalus, there is an imbalance between the rate of cerebral fluid being produced versus being absorbed into the bloodstream. This imbalance results in pressure inside the skull that can cause brain swelling, nerve damage, as well as other brain impairments. Although hydrocephalus is much more common for infants and older adults, it can occur at any age. Hydrocephalus can become more apparent by understanding the categories, symptoms and causes, along with effects and treatments of the condition.

Classifications of hydrocephalus are based on the explanation for the imbalance of cerebral fluid in the brain. Obstructive hydrocephalus, being the most common, is an imbalance due to an obstruction in the circulation of cerebral fluid. This obstruction can block fluid from properly circulating within or out of the brain. Poor absorption is a less occurring issue that inhibits the blood vessels from properly absorbing the cerebral fluid. The rare classification of overproduction is due to fluid being produced faster than the brain can move it into the bloodstream. In any of these three categories, there are multiple causes for the origin of hydrocephalus.

Congenital hydrocephalus occurs during pregnancy, birth, or infancy. This type of hydrocephalus is due to environmental or genetic factors that can cause malformation and narrowing of the ventricles. Congenital hydrocephalus could be categorized as obstructive, poor absorption, or both. The most characteristic symptoms of hydrocephalus in infants include an unusually sized head, irritability, vomiting, seizures, sleeplessness, and poor feeding habits. Acquired hydrocephalus occurs in older adults when they are incapable of draining the cerebral fluid due to obstruction or poor absorption. Communicating Hydrocephalus is classified as poor absorption because brain communication to circulate cerebral fluid is inhibited or abnormal. Overproduction can also play a part in communicating hydrocephalus if the rate of cerebral fluid production exceeds the rate of absorption.

There is no precise cause for any type of hydrocephalus, but those that occur after childhood are usually attributed to brain tumors or cysts, bleeding inside the brain, head trauma, infection, or any number of traumatic injuries to the brain. Symptoms are also common amongst those diagnosed in adulthood. Young and older adults may similarly experience headaches, difficult staying awake or waking up, loss of coordination and balance, loss of bladder control, impaired vision, and a decline in memory.

One main function of cerebral fluid is to regulate brain pressure and effects of blood pressure on the brain by flowing between the brain and spinal column. However, with a blockage in the absorption of the fluid, the function of pressure regulation is uncontrollable and numerous brain impairments could occur. Complications that arise from hydrocephalus can be extremely various, difficult to predict, and sometimes unable to recover from. In infants, hydrocephalus can lead to serious intellectual, developmental, and even physical disabilities. However, if responded to promptly by means of surgery, these complications could be partially or completely avoided. In adults, the effect of hydrocephalus is most commonly reflected by declined memory function and other cognitive abilities. Even after surgery to stabilize the condition takes place, recovery is usually insufficient and these symptoms may still be present.

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The standard surgical treatment for hydrocephalus is the placement of a shunt. The shunt allows for proper circulation of cerebral fluid through a surgical tube that originates in the ventricles of the brain and leads to another part of the body. This way, the fluid is transported away from the brain to be absorbed into the bloodstream. Another surgical process called a Ventriculostomy is the operation of creating a hole in a chosen ventricle to allow for proper flow. Although surgical treatments can often improve and stabilize cerebral fluid circulation, other forms of treatment may still be required for some individuals with hydrocephalus. With the benefits of surgery and other treatments, many people with hydrocephalus can live without feeling limited in their daily life.







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