Can hydrocephalus be treated?

Written by Chen Yu Fei
Neurosurgery
Updated on September 06, 2024
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Hydrocephalus can be effectively treated. Patients with hydrocephalus should first visit their local hospital for a cranial CT scan, and consider undergoing an MRI if necessary, to determine the primary causes and severity of the hydrocephalus and decide on the next treatment steps. For patients with underlying diseases, proactive treatment should be targeted at the cause, and effective surgical removal should be considered for intracranial space-occupying lesions. Patients with resistant hydrocephalus are advised to undergo regular check-ups and follow-ups, and for those with progressive obstructive hydrocephalus where the ventricular system is gradually expanding, surgical treatment is recommended.

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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.

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Written by Jiang Fang Shuai
Neurosurgery
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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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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.

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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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Is hydrocephalus easy to treat?

For patients with hydrocephalus, it is generally recommended to treat the condition surgically. Before the surgery, the patient should undergo a cranial CT or MRI to assess the type and severity of the hydrocephalus. If possible, a lumbar puncture should also be performed before the surgery to determine whether there is a significant increase in intracranial pressure, and a small amount of cerebrospinal fluid should be collected for routine and biochemical analysis of the cerebrospinal fluid. If there are no obvious contraindications to surgery, clinically, it is generally recommended to choose a ventriculoperitoneal shunt surgery. Most patients respond well to the surgery, and the morphology of the ventricular system gradually returns to normal.