Does hydrocephalus affect intelligence?

Written by Chen Yu Fei
Neurosurgery
Updated on September 02, 2024
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Mild hydrocephalus generally does not significantly affect intellectual levels, while moderate or severe hydrocephalus often impacts a patient’s intelligence. In children, it can cause severe impairment in intellectual development. For adults, it results in noticeable intellectual deficiencies, primarily characterized by significant cognitive dysfunction, reduced memory, diminished calculating abilities, and weakened verbal communication skills. Additionally, individuals may appear indifferent, speak less, are reluctant to interact with others, and have difficulty expressing themselves. Furthermore, most patients experience reduced orientation abilities concerning time, people, and space, which are predominantly caused by hydrocephalus.

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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.

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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.

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Causes of Hydrocephalus

Under normal conditions, the secretion, circulation, and absorption of cerebrospinal fluid (CSF) maintain a dynamic balance. In some pathological states, this balance is disrupted, leading to an excessive accumulation of CSF within the ventricular system, a condition known as hydrocephalus. Hydrocephalus can be classified into obstructive hydrocephalus and communicating hydrocephalus. The causes of obstructive hydrocephalus mainly include obstructions in the ventricular system, such as congenital malformations or abnormal development of the cerebral aqueduct, which are the most common causes of hydrocephalus in infants. In adults, tumors, bleeding, blockages, or compression of the ventricular system are also common causes of hydrocephalus. Communicating hydrocephalus results primarily from acquired diseases, such as cranial infections or blockages of arachnoid granulations by subarachnoid hemorrhage, leading to impairments in CSF absorption.

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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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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.