Can fetal hydrocephalus be kept?

Written by Gao Yi Shen
Neurosurgery
Updated on December 31, 2024
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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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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.

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Will hydrocephalus cause the fontanel to bulge?

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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Can hydrocephalus heal itself?

Hydrocephalus often does not heal on its own and is generally classified into different types, such as symptomatic hydrocephalus and asymptomatic hydrocephalus, obstructive hydrocephalus and non-obstructive hydrocephalus, communicating hydrocephalus, and non-communicating hydrocephalus, among others. Relatively speaking, patients with obstructive symptomatic hydrocephalus usually exhibit a progressively worsening condition. Without timely and effective treatment, patients may experience significant headaches, dizziness, nausea, vomiting, accompanied by motor dysfunction, difficulty walking, urinary and fecal incontinence, and other clinical manifestations. For these patients, early surgical intervention is advisable, as they often cannot heal on their own, and their condition will progressively worsen.

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Hydrocephalus Clinical Manifestations

In adults, hydrocephalus can be of the normal pressure type, mainly characterized by unsteady gait, slow responses, urinary and fecal incontinence, among others. There is also high-pressure hydrocephalus, which mainly presents as increased intracranial pressure, with the most common symptoms being headache, vomiting, papilledema, and ataxia. In children and infants, hydrocephalus has its own characteristics. In addition to some of the adult symptoms, there are also anomalies such as an abnormally increased head size, bulging fontanelles, "sunset" eye sign, intellectual and cognitive impairments, decreased vision, visual field defects, decreased hearing, epilepsy seizures, and more.