Causes of hydrocephalus in infants

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 14, 2024
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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 Jiang Fang Shuai
Neurosurgery
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Hydrocephalus Clinical Manifestations

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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Can hydrocephalus be effectively treated?

For patients with hydrocephalus, if timely and effective treatment can be obtained, most patients can achieve very good treatment results. For patients with progressive obstructive hydrocephalus, it is especially important to seize the time to perform surgical treatment in the early stages. Clinically, it is generally recommended to choose ventriculoperitoneal shunt surgery, placing a drainage tube in the patient's lateral ventricle, entering the peritoneal cavity through a subcutaneous tunnel, and draining the cerebrospinal fluid from the ventricle to the peritoneal cavity, thereby achieving the purpose of relieving the excessive cerebrospinal fluid in the ventricular system. After undergoing surgery, the patient's dilated bilateral lateral ventricles can effectively shrink, and conditions such as pre-existing cognitive dysfunction, limb motor dysfunction, and incontinence will improve.

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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.

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Is hydrocephalus easy to treat?

Hydrocephalus is relatively easy to treat. Before treatment, it is advised to first perform a cranial CT scan or MRI on the patient to determine the type and severity of the hydrocephalus, and based on whether the patient currently shows significant clinical symptoms, decide if surgical treatment is necessary. Additionally, a cranial CT or MRI can help identify the cause of the hydrocephalus, such as whether there is an intracranial space-occupying lesion or if the cerebral fluid circulation pathway is obstructed for other reasons, leading to hydrocephalus. If treatment is deemed necessary, it is generally recommended to opt for ventriculo-peritoneal shunt surgery for the patient. Most patients can achieve good results after the surgical treatment.

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Written by Chen Yu Fei
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How to alleviate pain from hydrocephalus?

For patients with hydrocephalus, if there is significant pain, it is mostly caused by increased intracranial pressure, often seen in progressive hydrocephalus, or obstructive hydrocephalus. As the cerebrospinal fluid gradually increases and accumulates, it leads to the expansion of the ventricular system and causes extensive hydrocephalus, accompanied by gradually increasing intracranial pressure. To alleviate the pain, one might consider taking oral long-acting analgesics to help relieve the pain. Additionally, the use of mannitol or performing a lumbar puncture to release a small amount of cerebrospinal fluid may be considered to ease the pain. However, the key is to achieve the ultimate resolution of the disease through surgery.