Anxiety, Depression and Hydrocephalus in Adults and NPH
How to Cope with Hydrocephalus
Hydrocephalus, commonly referred to aswater on the brain, is a neurological disorder in which there is an abnormal increase in the amount of fluid that accumulates within the brain. Most often occurring in infants and young children, this results with the skull becoming enlarged, increased intracranial pressure and the potential for brain damage.
Understanding Hydrocephalus and Its Causes
Grasp the meaning of the term:Hydrocephalus is a combination of two Greek words:hydromeaning water andcephalusmeaning head. Though once commonly referred to aswater on the brain, it is not water, but actually a clear liquid called cerebral spinal fluid, that surrounds the brain and spinal cord.
Learn the definition of the condition.The brain is comprised of four ventricles connected by narrow pathways. When pressure increases within the brain, due to a blockage or narrowing of one of these pathways, it results in a buildup of cerebral spinal fluid. This condition is calledhydrocephalus.
Understand the types of hydrocephalus.There are different types of the condition, each with unique characteristics and causes:
- Congenital Hydrocephalus:This condition occurs during pregnancy. It can be caused if the mother contracts rubella or mumps while pregnant. It can be the result of a birth defect, such as spina bifida, or the result of a genetic abnormality.
- Acquired Hydrocephalus:Infants can be susceptible to brain bleeding after delivery, especially in babies born prematurely. As well, central nervous system conditions such as meningitis can be hazardous. Head trauma and central nervous system tumors are also known to cause hydrocephalus.
- Communicating Hydrocephalus:When cerebral spinal fluid (CSF) becomes blocked after leaving a ventricle, but can still flow within the other ventricles of the brain, it is considered to becommunicating, as it is still flowing.
Non-Communicating Hydrocephalus:Also known asobstructivehydrocephalus, this occurs when one or more of the tiny vessels between the ventricles get blocked.
- Aqueductal Stenosis: This is one of the most common causes, where a narrowing of what is called aqueduct of Sylvius occurs. This is a passage between the third and fourth ventricles of the brain.
- Normal Pressure Hydrocephalus:Typically occurring in adults over the age of 60, this condition can result when there is an abnormal flow of CSF within the brain. Those who have experienced head trauma, an infection such as meningitis or have undergone brain surgery can be at risk. There are, however, cases in which the cause of the abnormality is unknown.
- Hydrocephalus Ex-Vacuo:After a stroke, traumatic brain injury, or degenerative disease such as Alzheimer's or Huntington's disease, brain tissue can actually shrink, causing the ventricles to get larger.
Recognizing Signs and Diagnosing
Be aware of the signs and symptoms.Though hydrocephalus typically affects infants, children and the elderly, hydrocephaluscanoccur at any age. The are a number signs to be aware of and they alter somewhat as we age.
Watch infants for:
- a build-up of fluid, causingbulgingin a baby'sfontanel(the soft spot on the top of a baby's head)
Watch toddlers and older children for:
- crossed eyes
- muscle spasms
- vomiting or nausea
Watch young to middle-aged adults for:
- chronic headaches
- loss on concentration
- difficulty walking
- bladder or vision problems
- poor memory
- difficulty concentrating
Watch adults over the age of 60 for:
- changes in walking patterns
- impaired mental functions
- trouble controlling urination or stools
Have a clinical evaluation performed.A neurologist starts with a clinical evaluation of the patient. As well, technology has provided specialists with a number of options to take images of the brain:
- CT(computed tomography)Scanning:A three-dimensional image of a body part, in this case the brain, taken in specific sections.
- MRI(magnetic resonance imaging):This noninvasive procedure takes computerized images of internal body tissues. Radio waves induce a nuclear magnetic resonance of atoms within the body which sends information, in the form of images, to the technician.
- Ultrasonography:This uses ultrasound to create a two-dimensional image that allows for the examination and detection of abnormalities in the body. This technique allows the technician to measure internal structures of the body, as well as any anomalies.
Have a shunt implanted.A system of tubing called ashuntis most often implanted. This allows the build up of cerebral spinal fluid to be diverted away from the central nervous system to another location in the body, where it can be absorbed.
- Ashuntconsists of three parts: a catheter, a valve, and the shunt. The procedure begins by placing one end of the catheter into the affected ventricle of the brain, or in an accumulation of CSF fluid outside of the spinal cord. The other end of the catheter is placed in a place suitable for draining, typically the abdomen, however a chamber of the heart or an area around the lung, can be suitable areas as well. The valve is placed along the catheter, maintaining the direction and flow of the draining fluid.
Undergo a ventriculostomy.A select number of individuals may be treated with a procedure called a thirdventriculostomy. This procedure can be used when the surgical area is difficult to reach. A small fibre optic scope with a camera is guided to the site of the blockage. A small hole is then made in the bottom of the third ventricle, allowing the CSF to drain and be reabsorbed into the fluid outside the brain.
Understand why complications can occur.As with any mechanical device, shunts can be susceptible to mechanical malfunction. There is also the possibility that the shunt may become blocked, or subject to infection. Also, lengthening or replacement of the catheter may be required at some point.
- When these incidents occur, surgical revision is typically required. Medical follow up with your doctor will often take place for months, even years after surgery.
Watch for signs complications.When one of the above complications occurs, it can cause the shunt system to over or under drain. There are also signs thatcanindicate infection.
- Over draining is a result of CSF being drained quicker than the body is able to produce it. This can cause headaches or hematoma (a swelling of clotting blood within the brain tissues).
- Under draining will display itself with symptoms of the original hydrocephalus condition.
- Infection will also display signs of the original hydrocephalus, but may also be accompanied by a fever and soreness is the muscles of the shoulders or neck. Redness or tenderness in the surgical area, along the length of the shunt, can also occur.
Seek medical attention when needed.Should there be any sign or suspicion that the patient is having problems with the shunt, medical help should be sought right away.
Living with Hydrocephalus
Consider the future.There are many factors involved in determining what life will look like for a person with hydrocephalus:
- Diagnosis made in a timely fashion
- The success of the surgery
- Any pre-existing medical conditions
Prepare for possible impairments.Both the patient and family should be prepared for potential for cognitive and physical impairment of some degree in a person who has hydrocephalus. When diagnosed early, most especially in babies and young children, patients can go on to lead normal, productive lives.
Minimizing Your Risk
Protect yourself and your children.Though there is not always a definitive reason as to why people are hydrocephalic, there are steps that you can take to protect yourself and your children against this condition:
- Ensure you get prenatal care through your pregnancy, as this can help reduce your chance of premature delivery, one of the causes of having a baby with hydrocephalus.
Keep up to date on vaccinations and have regular check ups.This will help avoid infections or conditions that can lead to hydrocephalus.
Always wear your seatbelt when in a moving vehicle.Babies and small children should always be in a proper car seat. Ensure that car seats and such items as baby carriages have proper safety certification.
Wear a helmet riding a bicycle, operating machinery or playing contact sports.Make sure the helmet is safety approved for the application in which you are using it.
Video: Anxiety, Depression and Hydrocephalus in the Pediatric Population
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