How to deal with hydrocephalus?

Written by Gao Yi Shen
Neurosurgery
Updated on September 08, 2024
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The treatment of hydrocephalus must clearly identify the severity of the condition. Hydrocephalus can be categorized into acute and chronic types. In cases of acute hydrocephalus, emergency ventricular puncture drainage surgery is required, otherwise, it may cause brain herniation leading to death. For chronic hydrocephalus, it is crucial to distinguish whether it is communicating hydrocephalus or obstructive hydrocephalus. For obstructive hydrocephalus, treatment options include creating a patency in the cerebral aqueduct and third ventriculostomy. For other types of hydrocephalus, ventriculoperitoneal shunt surgery can be performed. Therefore, it is essential to clearly determine the type of hydrocephalus to fundamentally select the appropriate surgical methods and instruments.

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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.

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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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Early manifestations of infant hydrocephalus

Infant hydrocephalus initially manifests as an enlarged head, beginning from birth with progressive increase in head circumference that is disproportionate to body growth. Upon examination, bulging fontanelles, thin scalp, and clearly visible scalp veins can be observed, with widened or even separated sutures. Additionally, due to increased intracranial pressure, symptoms such as irritability, recurrent vomiting, refusal to eat, abnormal behavior, and seizures may present as early indicators.

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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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Written by Chen Yu Fei
Neurosurgery
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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.