Hydrocephalus is a neurological disorder caused by the accumulation of cerebrospinal fluid in the brain’s ventricles, leading to increased pressure on brain tissues. It mainly affects children and can be congenital or acquired. There are two types of hydrocephalus: communicating and non-communicating. In adults, hydrocephalus falls into two categories: normal pressure hydrocephalus and hydrocephalus ex vacuo. Early diagnosis and treatment are crucial to prevent long-term problems.
Hydrocephalus is a medical term coined from the Greek words hydro for ‘water’ and cephalus for ‘head’. Previously known as water-in-the-head disease, hydrocephalus is an incurable neurological disorder characterized by excessive accumulation of cerebrospinal fluid (CSF) in the four ventricles of the brain. Cerebrospinal fluid is an essential fluid that surrounds the spinal cord and brain. It performs three vital functions: controlling the amount of blood flow within the brain; transport nutrients and proteins to the brain eliminating waste; and to cushion the brain from any shock. Once cerebrospinal fluid is produced, it flows normally through narrow pathways connecting the four ventricles and then exits at the base of the brain before being absorbed immediately into the bloodstream.
Hydrocephalus occurs when the production or absorption of CSF is disturbed, preventing the natural flow of CSF. As a result, cerebrospinal fluid builds up, resulting in abnormal expansion of the ventricles and thus increasing the pressure on the brain tissues. Prolonged cerebrospinal fluid pressure affects the blood supply to the brain and interferes with the brain’s ability to perform normal functions. Left undiagnosed and untreated, this condition can impair thinking, learning skills, and coordinated movement skills.
Hydrocephalus mainly affects children. It is diagnosed in one in 500 births and falls into one of two categories:
1. Congenital or acquired
Congenital hydrocephalus is already present at birth. It may be due to a genetic predisposition or environmental factors such as infections and prenatal bleeding, or bleeding in the fetus during fetal development. Meanwhile, acquired hydrocephalus appears during birth or is detected later. This type results from diseases such as meningitis, tumors and cysts. Head injuries and trauma can also cause this condition.
2. To communicate or not to communicate
Communicate hydrocephalus
it is a state in which cerebrospinal fluid flows normally between the four ventricles, but is blocked after exiting them. Contrary to that,
non-communicating hydrocephalus
or obstructive hydrocephalus, exists when the flow of cerebrospinal fluid is obstructed along the narrow pathways between the ventricles.
The incidence of hydrocephalus among adults is currently unknown. However, each case falls into one of two types:
3. Normal pressure hydrocephalus (NPH)
NPH is common among people over the age of 55. The main cause of NPH is trauma to the head, such as infection and bleeding within the brain. In this case, even though the ventricles are enlarged, the pressure within the brain remains unchanged. Left untreated, NPH will eventually lead to memory loss or dementia.
4. Hydrocephalus ex vacuo
This condition can occur in people of any age. It arises when there is severe damage to the brain, such as a traumatic injury or stroke. These injuries shrink brain tissue, allowing too much cerebrospinal fluid to enter the ventricles while maintaining a normal amount of pressure in the brain. Although this disorder is irreversible, it does not pose a health hazard and therefore does not require treatment.
It’s crucial to diagnose and treat hydrocephalus as early as possible to minimize or prevent the development of other long-term problems that affect learning and physical abilities.
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