Hydrocephalus - Causes, Symptoms and Treatment
Causes of hydrocephalus
Hydrocephalus is a disease of the central nervous system and in particular a structural disease of the brain. It may flow alone or accompanied by other congenital malformations, inflammatory, traumatic, genetic, metabolic and other diseases. The apperance of hydrocephalus is associated with disorder in the formation, circulation and resorbtion of the brain fluid (CSF).
Important role in this disorder have brain ventricles. Brain ventricles are a system of four interconnected cavities, in which circulates the brain fluid.
When one of the connecting roads is blocked, in the ventricle accumulate fluid and they expand - internal hydrocephalus. There is also external hydrocephalus, in which expands mainly subarachnoid space - between the surface of the brain and the meninges.Hydrocephalus is characterized by an increased volume of CSF, resulting in increased pressure in the brain cavities.
Common causes of this pathology are inflammations of the brain and the meninges –encephalitis, meningitis, meningoencephalitis. Also, excessively high or low levels of vitamin A in blood, intoxications and ionizing radiation can lead to hydrocephalus.
Symptoms of hydrocephalus
The first symptoms of hydrocephalus are crises of headache, nausea and vomiting. The increasiny of the volume of the skull progresses slowly and usually takes weeks or months until the diagnosis. When tapping the head can be heard a characteristic sound of “cracked pot”. As a result of increased intracranial pressure are found congestive papillaes in eye examination. The skull increases its size. The increased volume of the ventricles induces structural changes in the brain with progressive character, leading to atrophy of the brain substance.
Treatment of hydrocephalus
Treatment of hydrocephalus is primarily surgical and often has a life – saving nature. Surgery has several main objectives – the removal of the obstacle, which obstructs CSF – leading roads, creating a new route of CSF by detour the obstruction, moving flow drainage of CSF to other body cavities or introduction into the circulatory system. Modern treatment of hydrocephalus is based on shunting operations in which are placed special valve systems for drainage of CSF.
These operations are successful in 70-85% of cases. The decision for surgery must be taken after careful consideration on a case by case basis, having assessed all the evidence for it. Contraindicated for shunting operations are cases of patients with active inflammatory process, recent haemorrhage. Important and responsible task for the neurosurgeon is to select an adequate draining (shunt) system with an appropriate valve pressure.
Today are used different types of shunt systems that reduce by one-way drainage the volume and the surface of the ventricular system. Modern shunt systems must have maximum simplicity and efficiency. The ideal shunt system normalises the increased intracranial pressure and facilitates CSF drainage without causing insufficient flow of CSF or excess drainage.
The insufficient drainage or excess drainage are among the most common postoperative complications. The infectious complications are also common in the treatment of hydrocephalus, which requires removal of the shunt, antibiotic therapy and new shunting after the infection.