Hydrocephalus

Diagnosis

A neurological examination is used for diagnosing hydrocephalus. Typically, procedure used to make a diagnosis of hydrocephalus include:

• Neurological examination: Age will determine what kind of neurological examination is performed. The neurologist may asked questions and do quick tests in the clinic to assess the muscle tone, range of motion, general health, and sense of smell.
• Imaging tests: The following procedures may assist in the diagnosis of hydrocephalus and the determination of the root causes of the symptoms:
  • Ultrasound: This procedure is commonly employed as an initial assessment for infants due to its simplicity and low-risk nature. During the test, an ultrasound device is placed over the fontanel, the soft spot on the baby’s head. Additionally, ultrasound can be utilized during routine prenatal examinations to potentially identify hydrocephalus before birth.
  • Magnetic resonance imaging (MRI): A magnetic field and radio waves are used in this examination to provide precise photographs of the brain. Although this examination is painless, it is noisy, and one have to stay still. The enlarged ventricles brought on by too much cerebrospinal fluid can be seen on MRI scans. They can also be utilized to determine the underlying causes of hydrocephalus or other issues that may be causing the symptoms.

For some MRI scans, children may require some light sedation. However, certain medical facilities utilize a quick version of MRI that typically does not require any sedation.

• • Computed tomography (CT) scan: Cross-sectional images of the brain are produced using this specialized X-ray technology. Scanning is rapid and painless. CT scanning exposes patients to a modest amount of radiation while producing less detailed images than MRI. Hydrocephalus CT scans are typically reserved for urgent cases. A child typically receives a slight sedative for this test because it also demands lying still.

Adults frequently have additional testing to diagnose the disease. These tests could consist of spinal tap or lumbar puncture, monitoring of the intracranial pressure, and fundoscopic exam that examine the optic nerve at the back of the eye.

Treatment

Currently, brain surgery is the only possible option for treating hydrocephalus. In order to treat hydrocephalus, there are two different kinds of brain operations:

• Shunt: The most common treatment for hydrocephalus involves a surgical procedure to implant a medical device known as a shunt. This device consists of a flexible tube with a valve that is placed in the brain to regulate the flow of cerebrospinal fluid (CSF). The excess CSF is redirected through the tube to another part of the body, such as the abdomen or a heart chamber, where it can be absorbed more efficiently. This drainage system helps alleviate the pressure and fluid buildup in the brain.

Individuals with hydrocephalus typically require a shunt system for the remainder of their lives. Regular monitoring is essential to ensure the shunt is functioning properly and to address any complications that may arise. This treatment approach enables the ongoing management of hydrocephalus by effectively controlling the fluid levels in the brain, allowing individuals to lead a more normal and comfortable life.

• Endoscopic third ventriculostomy (ETV): Is a surgical procedure primarily conducted on children over the age of 2, involving the creation of a small hole in the floor of the third ventricle. This opening serves as a pathway for cerebrospinal fluid (CSF) to circulate in and around the brain, restoring its normal flow. Using a miniature video camera, the surgeon gains visual access to the brain and carefully punctures either the base of one ventricle or the space between them, allowing the CSF to drain out of the brain and alleviate the underlying condition.
• Other treatments: Hydrocephalus can require additional treatment for individuals, especially children, depending on the severity of its long-term complications. In the case of school-going children, the presence of special education teachers becomes crucial. These educators play a vital role in addressing any learning disabilities, evaluating educational requirements, and identifying the necessary resources to support the child’s educational journey.

Similarly, adults facing more severe complications stemming from hydrocephalus may require the assistance of various professionals. Occupational therapists, social workers, specialists in dementia care, and other medical experts might be necessary to provide comprehensive support. These professionals cater to the specific needs of adults with hydrocephalus, helping them manage their condition and enhancing their overall well-being.