What Is Hydrocephalus? https://www.webmd.

com/brain/hydrocephalus-facts

Hydrocephalus -- which roughly means “water on the brain” -- is the buildup of fluid
in the cavities (ventricles) deep within the brain. This fluid doesn’t flow or get
absorbed the way it should. That can lead to backups and blockages that put
pressure on your brain.

You’ve probably heard that the human body is mostly water. That’s true. From your
blood to the fluids that flow in and around your tissues and organs, liquid makes up
about 70% of your body.

Your head is no different. Your skull is filled with a fluid that surrounds your brain’s
folds and lobes. It’s called cerebrospinal fluid, and it cushions your brain from injuries
and has nutrients and proteins that help keep it healthy and working.

Hydrocephalus Symptoms

Symptoms of hydrocephalus can be different depending on your age. In babies, they

include:

● An unusually large head that gets bigger quickly

● The soft spot on top of a baby’s head is firm or bulging
● Eyes that are focused downward (sometimes called “sunsetting of the eyes”)
● Crankiness or irritability
● Vomiting or poor feeding
● Seizures
● Poor muscle tone and strength
● Less responsive to touch
● Poor growth

Hydrocephalus Causes

The three main causes of hydrocephalus are:

● A blockage. Tumors, cysts, birth defects, brain injury, or stroke can block or
affect the normal flow of cerebrospinal fluid.
 ● Poor fluid absorption. Inflammation, injuries, or infections like bacterial
meningitis can keep your brain tissues from taking in cerebrospinal fluid.
● Too much fluid. In rare cases, your body makes more cerebrospinal fluid than
your brain can handle, often due to infection like meningitis.

Types of Hydrocephalus

The four main types of hydrocephalus are:

● Congenital hydrocephalus. This is when someone is born with hydrocephalus.

● Compensated hydrocephalus. This shows up early in life -- sometimes before
birth -- but doesn’t cause symptoms until later in life.
● Acquired hydrocephalus. This is caused by a tumor, cyst, head injury, or a
brain infection.
● Normal pressure hydrocephalus. This usually shows up in older adults and
leads to a swelling in the small, open areas of the brain but without any
change in pressure. Doctors aren’t sure what causes this type.

Some experts refer to hydrocephalus as either “communicating” -- meaning the

cerebrospinal fluid is flowing freely -- or “non-communicating,” which is when there’s
a blockage.

Hydrocephalus Diagnosis

Your doctor will start with a physical examination and ask about your symptoms, then
recommend tests to look for signs of hydrocephalus. Tests may include:

● Neurological exam to check muscle strength, reflexes, coordination, balance,

vision, eye movement, hearing, mental functioning, and mood
● Magnetic resonance imaging (MRI), a scan that uses powerful magnets and
radio waves to make detailed images of your brain
● Computerized tomography (CT) scan, a series of X-rays taken from different
angles that are put together to make a more complete picture of your brain
● Spinal tap, when a doctor inserts a needle into the lower back in order to
remove and test some of the fluid
 ● Intracranial pressure monitoring (ICP), which uses a small monitor inserted
into the brain to measure how much swelling is there; intracranial pressure
can also be measured by EVD (external ventricular drain) or lumbar drain (like
a lumbar puncture but a small catheter stays in place to measure pressure
and to drain fluid).
● Fundoscopic exam, which looks at the nerve behind the eye to see if swelling
is present

Hydrocephalus Treatments

If your symptoms are mild, you may not need treatment. If they’re serious, your
doctor probably will recommend surgery to put a flexible plastic tube called a shunt in
your brain to redirect the cerebrospinal fluid into another part of your body, like your
belly. The shunt typically isn’t ever removed, and regular checkups are important to
make sure it’s working.

In some cases, hydrocephalus can be treated without using a shunt. One type of
surgery, endoscopic third ventriculostomy, opens a pathway in your brain so the fluid
can flow freely, while the other closes off the part of your brain that makes
cerebrospinal fluid. If your hydrocephalus is due to a tumor, the tumor can be
removed; if it is due to a stroke, the skull may be opened to relieve pressure and
swelling. Some medications help slow the production of CSF, such as acetazolamide
(Diamox).

Hydrocephalus Complications.

Complications of shunt systems can happen when the shunt is blocked and stops
working or when an infection occurs. This can cause cerebral spinal fluid to build up
again. Signs and symptoms may include:

● Headache
● Double vision or sensitivity to light
● Nausea or vomiting
● Soreness of the neck or shoulder muscles
● Seizures
If any previous hydrocephalus symptoms come back, it’s a sign of a complication.
Other things to look for include:

● Trouble waking up or staying awake. Get urgent care for this symptom
because it may lead to a coma.
● Swelling or redness along shunt tract
● Fever
● Prominent scalp veins in babies

Hydrocephalus Prevention

Some, but not all causes of hydrocephalus can be prevented.

● Safety gear such as helmets can help prevent head injuries while playing
sports, riding a bike, and other activities.
● Car seats and seatbelts can help protect children in the car.
● Regular health care during pregnancy can help lower the chances of
problems during pregnancy, including infection and premature birth.
● Meningitis was once a common cause of hydrocephalus. Ask your doctor
about a vaccine.

REACTION:
Hippocrates is credited with the first known reports of "water" around the brains of
macrocephalic children, though the term "hydrocephalus" was not coined until
Celsus' writings between 25 BC and 50 AD. Despite knowing little about the anatomy
and physiology of this enthralling problem at the time, anatomists such as Galen and
Antyllus attempted the first surgery, with predictably poor results. More recent
elucidation of the condition came from seventeenth century anatomists such as
Willis, Monroe, Magendie, and Luschka, who began to unravel the architecture of the
ventricular spaces and passageways within the brain, among others.

If left untreated, hydrocephalus is a chronic and fatal condition. It affects people of all
ages, with thousands of new cases reported each year in the United States and
many more worldwide. The current treatment for hydrocephalus is almost entirely
surgical, with iterative interventions frequently required for the condition's
management. As a result, the cost of treating hydrocephalus is a huge burden on the
United States and the rest of the world. As a result, there is a significant unmet
medical need for the development of pharmaceuticals and nonsurgical interventions
to treat hydrocephalus. In the last century, there has been little clinical progress in
this area, though there is an encouraging amount of emerging preclinical data for
small molecules, biologics, stem cell therapies, and gene therapies. More
comprehensive preclinical proof-of-mechanism studies in preclinical models, as well
as appropriate pharmacokinetic and pharmacodynamic studies, will undoubtedly
advance the standard of care for the treatment of hydrocephalus and improve the
quality of life for these patients.