How is hydrocephalus treated?

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 11, 2024
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Hydrocephalus is caused by the continuous increase of cerebrospinal fluid in the ventricular system of the brain. There are two types of hydrocephalus: obstructive hydrocephalus and communicating hydrocephalus, each with different treatment methods. Obstructive hydrocephalus is caused by obstructions such as tumors or blood clots, so removing tumors or clearing blood clots can relieve the obstruction and treat the hydrocephalus. On the other hand, communicating hydrocephalus usually has no obstruction; it is primarily caused by excessive production or insufficient absorption of cerebrospinal fluid. A common treatment is ventriculoperitoneal shunt surgery, which diverts cerebrospinal fluid from the ventricles to the abdominal cavity to treat hydrocephalus.

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Written by Jiang Fang Shuai
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Hydrocephalus Clinical Manifestations

In adults, hydrocephalus can be of the normal pressure type, mainly characterized by unsteady gait, slow responses, urinary and fecal incontinence, among others. There is also high-pressure hydrocephalus, which mainly presents as increased intracranial pressure, with the most common symptoms being headache, vomiting, papilledema, and ataxia. In children and infants, hydrocephalus has its own characteristics. In addition to some of the adult symptoms, there are also anomalies such as an abnormally increased head size, bulging fontanelles, "sunset" eye sign, intellectual and cognitive impairments, decreased vision, visual field defects, decreased hearing, epilepsy seizures, and more.

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Can hydrocephalus be treated?

Hydrocephalus can be effectively treated. Patients with hydrocephalus should first visit their local hospital for a cranial CT scan, and consider undergoing an MRI if necessary, to determine the primary causes and severity of the hydrocephalus and decide on the next treatment steps. For patients with underlying diseases, proactive treatment should be targeted at the cause, and effective surgical removal should be considered for intracranial space-occupying lesions. Patients with resistant hydrocephalus are advised to undergo regular check-ups and follow-ups, and for those with progressive obstructive hydrocephalus where the ventricular system is gradually expanding, surgical treatment is recommended.

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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.

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Causes of Hydrocephalus

Under normal conditions, the secretion, circulation, and absorption of cerebrospinal fluid (CSF) maintain a dynamic balance. In some pathological states, this balance is disrupted, leading to an excessive accumulation of CSF within the ventricular system, a condition known as hydrocephalus. Hydrocephalus can be classified into obstructive hydrocephalus and communicating hydrocephalus. The causes of obstructive hydrocephalus mainly include obstructions in the ventricular system, such as congenital malformations or abnormal development of the cerebral aqueduct, which are the most common causes of hydrocephalus in infants. In adults, tumors, bleeding, blockages, or compression of the ventricular system are also common causes of hydrocephalus. Communicating hydrocephalus results primarily from acquired diseases, such as cranial infections or blockages of arachnoid granulations by subarachnoid hemorrhage, leading to impairments in CSF absorption.

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Is hydrocephalus serious?

Hydrocephalus is a relatively severe neurological disorder, generally caused by disturbances in cerebrospinal fluid (CSF) circulation, leading to obstructive hydrocephalus due to blocked circulation pathways. Other causes include overproduction of CSF or reduced absorption, which can also lead to hydrocephalus. If the volume of hydrocephalus is not large, the clinical symptoms are generally not obvious, and the patient may only experience dizziness, slow response, cognitive impairment, and unstable walking. If the hydrocephalus is significant, it often causes severe compression of brain tissue, which can lead to consciousness disturbances, progressive dementia, epileptic seizures, and incontinence. Timely surgical intervention is necessary to relieve the pressure caused by the edema.