How is hydrocephalus treated?

Written by Chen Yu Fei
Neurosurgery
Updated on September 25, 2024
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If hydrocephalus is suspected, it is advised to first visit a local hospital for an emergency cranial CT scan to determine the type and severity of the hydrocephalus. This helps identify the main causes of the condition and whether it is communicating or non-communicating hydrocephalus. Treatment plans should then be based on the patient's symptoms and physical signs. For those with obvious clinical symptoms of obstructive hydrocephalus, surgery is often recommended. Clinically, a ventriculoperitoneal shunt surgery is generally chosen. Through surgical intervention, original symptoms can gradually alleviate or even disappear, and the morphology of the ventricular system can progressively return to normal.

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How should hydrocephalus be treated?

Treatment of hydrocephalus must be specific to the patient's condition, as different cases of hydrocephalus require different treatment approaches. For some mild cases of hydrocephalus without obvious clinical symptoms, the focus is on observation or the use of internal medicine to improve cerebral circulation and neuroprotective medications. However, if symptoms emerge later and significantly affect daily life, shunt surgery from the cerebral ventricles to the abdominal cavity is performed for chronic hydrocephalus, aiming to alleviate the patient's suffering. In cases of acute hydrocephalus caused by cerebral hemorrhage or subarachnoid hemorrhage, treatment might involve the use of neuroendoscopy to create a ventriculostomy at the floor of the third ventricle or external ventricular drainage. Thus, treatment is determined based on the specific circumstances.

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Causes of hydrocephalus

There are many causes of hydrocephalus, and it is important to make specific judgments based on the circumstances. In some infants, congenital hydrocephalus can be caused by intracranial birth injuries, which occur during the birth process and lead to intracranial hemorrhaging. It can also be due to congenital developmental abnormalities, such as anencephaly or spina bifida. In adults, hydrocephalus can be caused by intracranial tumors, such as choroid plexus papillomas, which overproduce cerebrospinal fluid. Others might develop hydrocephalus due to blockages caused by blood clots, such as cerebral hemorrhage or subarachnoid hemorrhage. There are also cases where hydrocephalus can occur alongside chronic conditions like subdural hematoma or epidural hematoma, depending on the specific clinical presentations of the patients.

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Is hydrocephalus serious?

Hydrocephalus is relatively serious. When hydrocephalus occurs, it gradually affects the patient's motor functions of the limbs, causing weakness in one or both sides, difficulty in lifting, walking impairments, difficulty performing fine motor actions, and ataxia. It may even lead to frequent falls. Additionally, there are significant cognitive impairments, characterized by reduced intelligence levels, decreased computational abilities, and even certain degrees of language dysfunctions. Patients may also exhibit significant personality changes, such as feelings of anxiety, depression, apathetic expressions, and a dislike for communication and interaction with others.

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How to prevent hydrocephalus?

To prevent hydrocephalus, it is first recommended to cultivate good living habits, such as a diet low in salt and fat, and light in nature. Avoid eating overly greasy, spicy, and irritating foods. Additionally, engage in aerobic exercise daily, keeping it under 30 minutes, which can effectively prevent the occurrence of hydrocephalus. For patients with severe cranial trauma or serious central nervous system infections, toxic encephalopathy, etc., if the patient's condition is stable, a timely follow-up head CT scan should be conducted to dynamically observe changes in the patient’s condition. Furthermore, if some patients do not have clear contraindications for surgery, considering a lumbar puncture might be an option to maintain the fluid flow in the brain and prevent hydrocephalus.

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Does hydrocephalus affect intelligence?

Mild hydrocephalus generally does not significantly affect intellectual levels, while moderate or severe hydrocephalus often impacts a patient’s intelligence. In children, it can cause severe impairment in intellectual development. For adults, it results in noticeable intellectual deficiencies, primarily characterized by significant cognitive dysfunction, reduced memory, diminished calculating abilities, and weakened verbal communication skills. Additionally, individuals may appear indifferent, speak less, are reluctant to interact with others, and have difficulty expressing themselves. Furthermore, most patients experience reduced orientation abilities concerning time, people, and space, which are predominantly caused by hydrocephalus.