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Hydrocephalus
Can hydrocephalus be drained?
For patients with hydrocephalus, surgery is generally recommended. A common surgical option is the ventriculo-peritoneal shunt procedure, where a drain tube is placed in the patient's ventricular system. Through this surgery, excess cerebrospinal fluid is drained from the ventricular system to the patient's abdominal cavity, achieving a new balance. Most patients who undergo surgery achieve desirable outcomes, with initial symptoms and physical signs likely improving gradually. Over time, the patient's ventricular system may reduce in size, and may even return to normal. Therefore, for most patients with hydrocephalus, the surgical outcome is quite certain, and it is advised to opt for surgery at an early stage.
Hydrocephalus should be treated in the neurology department.
If you have hydrocephalus, it is recommended to visit the neurosurgery department at your local hospital and ask a neurosurgeon to assess your current condition. It is generally advised that patients undergo a cranial CT scan or MRI to determine the extent and severity of the hydrocephalus and to choose the appropriate treatment method. For static hydrocephalus, most patients do not exhibit clear clinical symptoms and generally do not require special treatment, regular monitoring is sufficient. For progressive hydrocephalus, surgical treatment is often necessary, and it is generally recommended that patients undergo ventriculoperitoneal shunt surgery. With surgical treatment, most patients can achieve satisfactory results.
Causes of hydrocephalus
There are many causes of hydrocephalus, and it is important to make specific judgments based on the circumstances. In some infants, congenital hydrocephalus can be caused by intracranial birth injuries, which occur during the birth process and lead to intracranial hemorrhaging. It can also be due to congenital developmental abnormalities, such as anencephaly or spina bifida. In adults, hydrocephalus can be caused by intracranial tumors, such as choroid plexus papillomas, which overproduce cerebrospinal fluid. Others might develop hydrocephalus due to blockages caused by blood clots, such as cerebral hemorrhage or subarachnoid hemorrhage. There are also cases where hydrocephalus can occur alongside chronic conditions like subdural hematoma or epidural hematoma, depending on the specific clinical presentations of the patients.
Manifestations of Hydrocephalus
For hydrocephalus, it often manifests as noticeable enlargement of the ventricular system. Additionally, patients experience symptoms of increased intracranial pressure such as headaches, dizziness, nausea, and dry heaves. Severe hydrocephalus can lead to significant increases in intracranial pressure, with patients suffering from severe headaches, dizziness, and even accompanied by papilledema, decreased vision, visual field defects, and optic atrophy. Furthermore, patients with hydrocephalus may exhibit significant cognitive dysfunction, characterized by reduced intelligence levels, diminished learning ability, computational skills, and memory loss. The physical motor functions of patients also gradually decline, presenting as unstable walking, a propensity to fall, and even possibly accompanied by urinary and fecal incontinence.
How should hydrocephalus be treated?
Treatment of hydrocephalus must be specific to the patient's condition, as different cases of hydrocephalus require different treatment approaches. For some mild cases of hydrocephalus without obvious clinical symptoms, the focus is on observation or the use of internal medicine to improve cerebral circulation and neuroprotective medications. However, if symptoms emerge later and significantly affect daily life, shunt surgery from the cerebral ventricles to the abdominal cavity is performed for chronic hydrocephalus, aiming to alleviate the patient's suffering. In cases of acute hydrocephalus caused by cerebral hemorrhage or subarachnoid hemorrhage, treatment might involve the use of neuroendoscopy to create a ventriculostomy at the floor of the third ventricle or external ventricular drainage. Thus, treatment is determined based on the specific circumstances.
Will hydrocephalus cause the fontanel to bulge?
Hydrocephalus comes in two types: obstructive hydrocephalus and communicating hydrocephalus. Obstructive hydrocephalus is characterized by the inability of cerebrospinal fluid (CSF) to flow from the brain to the spinal cord, preventing normal circulation. In this situation, the pressure inside the skull can gradually increase due to the buildup of fluid, potentially leading to the progressive bulging of a child's fontanel. On the other hand, communicating hydrocephalus involves the CSF being able to circulate between the brain cavities and the spinal cord, merely resulting in an enlargement of the ventricles without the bulging of the fontanel.
Can fetal hydrocephalus be kept?
Whether fetal hydrocephalus should result in termination must be determined based on a specific analysis of the particular medical condition at that time. Fetal hydrocephalus is merely a manifestation of an illness. It is essential to understand the root cause of the hydrocephalus to make a clear decision regarding the options available. If the hydrocephalus is combined with cranial malformations or abnormalities in the cerebral gyri and sulci or other congenital development defects, in general, such conditions are not survivable even into adulthood. There is no possibility of survival, and even if surgery is performed later, it cannot provide an effective treatment. However, in cases where conditions such as spina bifida occur, with active surgical intervention, these can have a very positive prognosis. Therefore, it is crucial to clearly identify the specific medical condition at the time to determine the most appropriate course of action.
Can hydrocephalus heal itself?
Hydrocephalus often does not heal on its own and is generally classified into different types, such as symptomatic hydrocephalus and asymptomatic hydrocephalus, obstructive hydrocephalus and non-obstructive hydrocephalus, communicating hydrocephalus, and non-communicating hydrocephalus, among others. Relatively speaking, patients with obstructive symptomatic hydrocephalus usually exhibit a progressively worsening condition. Without timely and effective treatment, patients may experience significant headaches, dizziness, nausea, vomiting, accompanied by motor dysfunction, difficulty walking, urinary and fecal incontinence, and other clinical manifestations. For these patients, early surgical intervention is advisable, as they often cannot heal on their own, and their condition will progressively worsen.
Symptoms of hydrocephalus
For patients with hydrocephalus, it often leads to a series of symptoms and signs. For example, patients may experience mild cognitive impairments, manifesting as obvious memory loss, reduced intelligence, and weakened orientation ability in terms of time, space, and person recognition. In addition, most patients also suffer from motor dysfunction, showing symptoms like weakness in one or both legs, difficulty walking, unstable gait, and a tendency to fall. Some patients might even experience changes in emotion and personality. As the condition of cerebral hemorrhage gradually progresses, patients may exhibit symptoms of increased intracranial pressure.
Symptoms of hydrocephalus in children
For pediatric hydrocephalus, a range of specific symptoms and signs will appear. For instance, children may repeatedly complain of headaches, dizziness, nausea, vomiting, accompanied by a strong sense of vertigo. Through physical examination, it can be found that the head circumference of the child is significantly larger than that of normal children, with the anterior fontanelle full and bulging. Special physical examinations may reveal the presence of a sunset sign or a cracked pot sound. In addition, some children may exhibit certain levels of cognitive dysfunction, lower intellectual development, significantly lagging behind peers, and they might also show instability in walking, swaying back and forth, prone to falling, or even experience urinary and fecal incontinence.