With the term hydrocephalus the accumulation of is identified cerebrospinal fluid (or liquor) in the cerebral ventricles, which consequently they increase in volumeThe name of the pathology, deriving from the Greek, literally means “water in the head”.
What is liquor used for?
The cerebrospinal fluid, which surrounds the brain and spinal cord, is actually very similar to water. This fluid plays a fundamental and multifaceted role:
- protects the spinal cord and brain from possible trauma
- brings nutrients to the brain and eliminates harmful ones
- balances intracranial and intravertebral pressure variations
Hydrocephalus: the causes
Among the most common causes of hydrocephalus are: cerebral hemorrhages (related to aneurysm), brain tumors, trauma, meningitis and infections, hemorrhagic complications in premature infantsMore rarely it can be considered a hereditary pathology, but it can be linked to pathologies of fetal development, such as spina bifida and encephaloceleThe most affected subjects are children (congenital hydrocephalus) and adults over 60 years old (normal pressure hydrocephalus).
Hydrocephalus and symptoms by age group
The symptoms of hydrocephalus vary depending on the patient's age:
- neonate: abnormal increase in head circumference, tense and swollen fontanel, thin and taut scalp skin with prominent veins, separation between the skull bones, vomiting, irritability, downward gaze deviation (setting sun sign), loss of appetite, drowsiness
- child: abnormal increase in head circumference in the first year of life, headache, vomiting, nausea, fever, visual disturbances (double vision and dimming), irritability, drowsiness, loss of balance and coordination, delay in walking and speaking, lack of concentration, character disorders, loss of sensory and motor functions, epileptic seizures, loss of appetite
- healthier skin : headache, difficulty waking up and staying awake, lack of balance and coordination, urinary incontinence, vision problems, cognitive impairments that impair intellect and work activities
- adult and elderlyGait disturbances, urinary incontinence, foot dragging, memory loss, dementia. The latter must be carefully investigated, as it is necessary to distinguish a symptom of normal pressure hydrocephalus from one of Alzheimer's disease.
Hydrocephalus: diagnosis and treatment
A thorough examination by your primary care physician and a complete neurological exam are the first steps to reaching a definitive diagnosis of hydrocephalus. Depending on the patient's age, the instrumental tests to be performed are: Ultrasound for newborns, brain MRI for children, brain CT or MRI for young people, adults and the elderlyTreatment is determined based on the causes of hydrocephalus, the severity of the condition, and the patient's condition. If hydrocephalus is caused by a tumor or malformation, it can be intervene directly on the cause. It is also possible drain the fluid elsewhere, through a valve, specially implanted just under the hair or behind the ear, and two cathetersThis instrument is constantly in operation and must remain in that location for its entire life. Alternatively, a reset operation can be performed. third ventriculostomy: the procedure, performed with the aid of an endoscope that allows internal visualization, opens a new passage for the cerebrospinal fluid on the floor of the third ventricle.
Recovery and life expectancy
Immediately after any surgical procedure, neurological functions should be measured and compared with those present before the operation. If the symptoms persist, a specific rehabilitationIf the patient has had a drainage shunt implanted, it is necessary constantly monitor the valve's operation via CT or MRI of the brain, as it should be check the positioning of the catheters with abdominal X-rays and ultrasound. It is essential to contact your doctor promptly if you experience pain, redness, tenderness, or swelling in the incision area or along the tube; drowsiness; irritability; fever; nausea; vomiting; headache; double vision; abdominal pain; or previously experienced neurological symptoms. If the valve malfunctions, causing the recurrence of hydrocephalus symptoms, replacement is possible, which is generally curative. The prognosis is strictly linked to the origin of the hydrocephalus, symptoms, and response to treatment. Consequently, It is very difficult to make a prediction for the patient's recovery. A weighty element in this path is the timeliness, both in diagnosis and treatment. If left untreated, congenital hydrocephalus unfortunately does not have a long life expectancy: approximately 4 years.
