Will hydrocephalus cause the fontanel to bulge?

Written by Liu Dong Yang
Neurosurgery
Updated on January 09, 2025
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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.

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How to prevent hydrocephalus?

To prevent hydrocephalus, it is first recommended to cultivate good living habits, such as a diet low in salt and fat, and light in nature. Avoid eating overly greasy, spicy, and irritating foods. Additionally, engage in aerobic exercise daily, keeping it under 30 minutes, which can effectively prevent the occurrence of hydrocephalus. For patients with severe cranial trauma or serious central nervous system infections, toxic encephalopathy, etc., if the patient's condition is stable, a timely follow-up head CT scan should be conducted to dynamically observe changes in the patient’s condition. Furthermore, if some patients do not have clear contraindications for surgery, considering a lumbar puncture might be an option to maintain the fluid flow in the brain and prevent hydrocephalus.

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Symptoms of hydrocephalus in children

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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Can fetal hydrocephalus be kept?

Whether fetal hydrocephalus should result in termination must be determined based on a specific analysis of the particular medical condition at that time. Fetal hydrocephalus is merely a manifestation of an illness. It is essential to understand the root cause of the hydrocephalus to make a clear decision regarding the options available. If the hydrocephalus is combined with cranial malformations or abnormalities in the cerebral gyri and sulci or other congenital development defects, in general, such conditions are not survivable even into adulthood. There is no possibility of survival, and even if surgery is performed later, it cannot provide an effective treatment. However, in cases where conditions such as spina bifida occur, with active surgical intervention, these can have a very positive prognosis. Therefore, it is crucial to clearly identify the specific medical condition at the time to determine the most appropriate course of action.

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Is hydrocephalus serious?

Hydrocephalus is a relatively severe neurological disorder, generally caused by disturbances in cerebrospinal fluid (CSF) circulation, leading to obstructive hydrocephalus due to blocked circulation pathways. Other causes include overproduction of CSF or reduced absorption, which can also lead to hydrocephalus. If the volume of hydrocephalus is not large, the clinical symptoms are generally not obvious, and the patient may only experience dizziness, slow response, cognitive impairment, and unstable walking. If the hydrocephalus is significant, it often causes severe compression of brain tissue, which can lead to consciousness disturbances, progressive dementia, epileptic seizures, and incontinence. Timely surgical intervention is necessary to relieve the pressure caused by the edema.

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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.