The term hydrocephalus comes from two Latin words: hydro, meaning water, and cephalous , meaning head. Hydrocephalus describes an abnormal increase in fluid that fills and floats in the central nervous system (brain and spinal cord) under normal conditions. This fluid is known as cephalo-rachidian fluid (abbreviated as lcr).
Types of hydrocephalus
There are different types of hydrocephalus. Basically, they can be differentiated as they are presented:
- Acute hydrocephalus or rapid presentation : if it is in hours or days.
- Chronic hydrocephalus : when it arises slowly and progressively over days, weeks or months.
It can also be classified according to the existence of obstacles in the flow channels of the cephalo-spinal fluid:
- Obstructive or non-communicating hydrocephalus , when there is an obstacle.
- Non-obstructive or communicating hydrocephalus , when there is no obstacle.
Symptoms of hydrocephalus
The specialists in Neurosurgery state that the symptoms will depend on the type of hydrocephalus.
In those presenting rapid or acute , the symptoms are usually striking and severe: headache that does not improve with regular medication, nausea, vomiting without previous nausea, tendency to sleep with difficulty staying awake, including epileptic seizures. If not treated quickly, it can progress to neurological coma and death.
In cases of chronic presentation , the symptoms are usually less noticeable and dilated in time, although progressive in intensity. For that reason, it may be difficult to detect them or differentiate them from other neurological diseases such as Parkinson's or dementia, or other health problems in older people.. Normally, the first symptom is usually a slow and progressive deterioration in the way of walking, dragging and separating the feet with instability and falls.
Later, there is usually an inability to withstand urine that progresses to incontinence and memory failures, clumsiness or increasingly frequent deficits that progress to dementia if hydrocephalus is not treated.
Causes of hydrocephalus
The causes of hydrocephalus are multiple and very numerous. Among them are tumors, brain hemorrhages, brain infections, brain radiotherapy, severe head injuries, brain malformations, such as Arnold-Chiari syndrome, etc.. Sometimes, children are already born with hydrocephalus (congenital) or develop it in childhood for any of these reasons or for no apparent reason.
Also, elderly patients of a certain age begin to develop symptoms of chronic hydrocephalus, which is called normotensive hydrocephalus or chronic hydrocephalus of the adult, which is an important diagnosis to rule out as a cause of treatable dementia with good prognosis (other causes of dementia). they are not treatable or they are not of good prognosis).
It is a surgical treatment performed by the neurosurgeon. Depending on the type of hydrocephalus and its cause, a type of surgery or other. The two basic ways to treat hydrocephalus are:
- Derivations of cerebrospinal fluid , which in turn can be:- External or temporary: external ventricular drainages.- Internal and definitive: they are known as ventriculo-peritoneal or lumbo-peritoneal shunts, fundamentally.
In these cases, an intracerebral tube is placed to give an alternative outlet to the fluid accumulated towards the outside of the body or to other parts of it (peritoneum, atrium, etc.).. It is usually performed in elderly patients and in hydrocephalus without obvious obstruction to fluid flow.
- Endoscopic treatment or endoscopic premamilar ventriculostomy. Through a cerebral endoscope, through a hole in the skull of 14 mm, communicate the cerebral ventricles where the liquid accumulates by an obstruction with the floor of the brain, without leaving tubes or prosthesis.
Are there people more likely than others to suffer from it?
Yes. People who suffer from hemorrhages, tumors, or brain infections; or the elderly with cranial traumas or without them, but with symptoms of dementia and deterioration of their gait; they must be closely monitored for having a greater frequency of presentation of hydrocephalus.