Symptoms of hydrocephalus in children

Written by Chen Yu Fei
Neurosurgery
Updated on September 26, 2024
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For pediatric hydrocephalus, a range of specific symptoms and signs will appear. For instance, children may repeatedly complain of headaches, dizziness, nausea, vomiting, accompanied by a strong sense of vertigo. Through physical examination, it can be found that the head circumference of the child is significantly larger than that of normal children, with the anterior fontanelle full and bulging. Special physical examinations may reveal the presence of a sunset sign or a cracked pot sound. In addition, some children may exhibit certain levels of cognitive dysfunction, lower intellectual development, significantly lagging behind peers, and they might also show instability in walking, swaying back and forth, prone to falling, or even experience urinary and fecal incontinence.

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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.

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Written by Shu Zhi Qiang
Neurosurgery
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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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Written by Chen Yu Fei
Neurosurgery
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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 Tang Li Li
Neurology
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How to relieve headache caused by hydrocephalus?

Hydrocephalus causing headaches is generally related to high pressure in the brain. Hydrocephalus leads to an enlargement of the ventricular system, compressing the surrounding brain tissue. Since the volume of the skull is fixed, increased accumulation of fluid can cause a rapid rise in internal pressure, leading to headaches. In severe cases, it may cause nausea, vomiting, and disturbances in consciousness, making the patient drowsy, stuporous, or even comatose. In such cases, the main treatment is to reduce the pressure inside the brain. Dehydrating agents, such as mannitol, can be used; however, mannitol mainly removes water from inside the cells and is more effective for cerebral edema than for hydrocephalus. Furosemide can be used to reduce the secretion of cerebrospinal fluid and may have some effect on hydrocephalus. However, the key treatment is likely to be surgical, such as lateral ventricular drainage, which can fundamentally resolve the problem of fluid accumulation but can also lead to complications like infections.

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Written by Chen Yu Fei
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How is hydrocephalus treated?

If hydrocephalus is suspected, it is advised to first visit a local hospital for an emergency cranial CT scan to determine the type and severity of the hydrocephalus. This helps identify the main causes of the condition and whether it is communicating or non-communicating hydrocephalus. Treatment plans should then be based on the patient's symptoms and physical signs. For those with obvious clinical symptoms of obstructive hydrocephalus, surgery is often recommended. Clinically, a ventriculoperitoneal shunt surgery is generally chosen. Through surgical intervention, original symptoms can gradually alleviate or even disappear, and the morphology of the ventricular system can progressively return to normal.