Causes of Hydrocephalus

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 18, 2024
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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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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.

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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.

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Can hydrocephalus be treated?

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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Does hydrocephalus affect intelligence?

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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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.