Causes of hydrocephalus in infants

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 14, 2024
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The occurrence of hydrocephalus in infants involves congenital factors, including poor brain development caused by exposure to medications, radiation, rays, and viral or bacterial infections during the embryonic stage, leading to hydrocephalus. Infant hydrocephalus also includes some acquired factors, such as birth injuries occurring during delivery, and post-birth conditions like inflammation in the brain, tumors, or arachnoid cysts. These conditions can lead to excessive production of cerebrospinal fluid, impaired circulation, or insufficient absorption, resulting in hydrocephalus.

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Written by Jiang Fang Shuai
Neurosurgery
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Early manifestations of infant hydrocephalus

Infant hydrocephalus initially manifests as an enlarged head, beginning from birth with progressive increase in head circumference that is disproportionate to body growth. Upon examination, bulging fontanelles, thin scalp, and clearly visible scalp veins can be observed, with widened or even separated sutures. Additionally, due to increased intracranial pressure, symptoms such as irritability, recurrent vomiting, refusal to eat, abnormal behavior, and seizures may present as early indicators.

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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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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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How to relieve headache caused by hydrocephalus?

Hydrocephalus causing headaches is generally related to high pressure in the brain. Hydrocephalus leads to an enlargement of the ventricular system, compressing the surrounding brain tissue. Since the volume of the skull is fixed, increased accumulation of fluid can cause a rapid rise in internal pressure, leading to headaches. In severe cases, it may cause nausea, vomiting, and disturbances in consciousness, making the patient drowsy, stuporous, or even comatose. In such cases, the main treatment is to reduce the pressure inside the brain. Dehydrating agents, such as mannitol, can be used; however, mannitol mainly removes water from inside the cells and is more effective for cerebral edema than for hydrocephalus. Furosemide can be used to reduce the secretion of cerebrospinal fluid and may have some effect on hydrocephalus. However, the key treatment is likely to be surgical, such as lateral ventricular drainage, which can fundamentally resolve the problem of fluid accumulation but can also lead to complications like infections.

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Is hydrocephalus easy to treat?

Hydrocephalus is relatively easy to treat. Before treatment, it is advised to first perform a cranial CT scan or MRI on the patient to determine the type and severity of the hydrocephalus, and based on whether the patient currently shows significant clinical symptoms, decide if surgical treatment is necessary. Additionally, a cranial CT or MRI can help identify the cause of the hydrocephalus, such as whether there is an intracranial space-occupying lesion or if the cerebral fluid circulation pathway is obstructed for other reasons, leading to hydrocephalus. If treatment is deemed necessary, it is generally recommended to opt for ventriculo-peritoneal shunt surgery for the patient. Most patients can achieve good results after the surgical treatment.