Hydrocephalus Clinical Manifestations

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 11, 2024
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In adults, hydrocephalus can be of the normal pressure type, mainly characterized by unsteady gait, slow responses, urinary and fecal incontinence, among others. There is also high-pressure hydrocephalus, which mainly presents as increased intracranial pressure, with the most common symptoms being headache, vomiting, papilledema, and ataxia. In children and infants, hydrocephalus has its own characteristics. In addition to some of the adult symptoms, there are also anomalies such as an abnormally increased head size, bulging fontanelles, "sunset" eye sign, intellectual and cognitive impairments, decreased vision, visual field defects, decreased hearing, epilepsy seizures, and more.

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Written by Shu Zhi Qiang
Neurosurgery
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What is hydrocephalus shunt?

Patients with hydrocephalus usually require shunt surgery, among which the most common is the ventriculoperitoneal shunt. The shunt tube used in this surgery typically features a reservoir, often referred to by patients as a "water basket". Patients are frequently required to press this reservoir to promote the excess cerebral spinal fluid to flow through the shunt tube into the abdominal cavity, where it is absorbed by the omentum. If the reservoir is not pressed, the shunt tube may become blocked, potentially requiring the surgery to be performed again.

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Written by Jiang Fang Shuai
Neurosurgery
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Causes of hydrocephalus in infants

The occurrence of hydrocephalus in infants involves congenital factors, including poor brain development caused by exposure to medications, radiation, rays, and viral or bacterial infections during the embryonic stage, leading to hydrocephalus. Infant hydrocephalus also includes some acquired factors, such as birth injuries occurring during delivery, and post-birth conditions like inflammation in the brain, tumors, or arachnoid cysts. These conditions can lead to excessive production of cerebrospinal fluid, impaired circulation, or insufficient absorption, resulting in hydrocephalus.

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Written by Chen Yu Fei
Neurosurgery
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Is hydrocephalus serious?

Hydrocephalus is relatively serious. When hydrocephalus occurs, it gradually affects the patient's motor functions of the limbs, causing weakness in one or both sides, difficulty in lifting, walking impairments, difficulty performing fine motor actions, and ataxia. It may even lead to frequent falls. Additionally, there are significant cognitive impairments, characterized by reduced intelligence levels, decreased computational abilities, and even certain degrees of language dysfunctions. Patients may also exhibit significant personality changes, such as feelings of anxiety, depression, apathetic expressions, and a dislike for communication and interaction with others.

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Written by Jiang Fang Shuai
Neurosurgery
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How is hydrocephalus treated?

Hydrocephalus is caused by the continuous increase of cerebrospinal fluid in the ventricular system of the brain. There are two types of hydrocephalus: obstructive hydrocephalus and communicating hydrocephalus, each with different treatment methods. Obstructive hydrocephalus is caused by obstructions such as tumors or blood clots, so removing tumors or clearing blood clots can relieve the obstruction and treat the hydrocephalus. On the other hand, communicating hydrocephalus usually has no obstruction; it is primarily caused by excessive production or insufficient absorption of cerebrospinal fluid. A common treatment is ventriculoperitoneal shunt surgery, which diverts cerebrospinal fluid from the ventricles to the abdominal cavity to treat hydrocephalus.

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Written by Chen Yu Fei
Neurosurgery
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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.