Hydrocephalus MRI manifestations

Written by Chen Yu Fei
Neurosurgery
Updated on June 21, 2025
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For patients with hydrocephalus, an examination using cranial MRI often shows significant dilation of the ventricular system, especially in patients with communicating hydrocephalus, where the entire ventricular system can appear significantly dilated. Once such a condition is discovered, it is advisable to promptly visit a local hospital and consult a neurosurgeon to help assess the current situation, mainly to determine the primary cause of the hydrocephalus, as targeted treatment can only be conducted once the cause is identified. For severe cases of hydrocephalus, surgery is generally recommended, and clinically, a ventriculoperitoneal shunt procedure is commonly chosen.

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Written by Chen Yu Fei
Neurosurgery
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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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Written by Gao Yi Shen
Neurosurgery
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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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Written by Gao Yi Shen
Neurosurgery
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How to deal with hydrocephalus?

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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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 Jiang Fang Shuai
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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.