Does hydrocephalus affect intelligence?

Written by Chen Yu Fei
Neurosurgery
Updated on September 02, 2024
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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 in infants

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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How is hydrocephalus treated?

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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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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Can hydrocephalus be drained?

For patients with hydrocephalus, surgery is generally recommended. A common surgical option is the ventriculo-peritoneal shunt procedure, where a drain tube is placed in the patient's ventricular system. Through this surgery, excess cerebrospinal fluid is drained from the ventricular system to the patient's abdominal cavity, achieving a new balance. Most patients who undergo surgery achieve desirable outcomes, with initial symptoms and physical signs likely improving gradually. Over time, the patient's ventricular system may reduce in size, and may even return to normal. Therefore, for most patients with hydrocephalus, the surgical outcome is quite certain, and it is advised to opt for surgery at an early stage.

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Manifestations of Hydrocephalus

For hydrocephalus, it often manifests as noticeable enlargement of the ventricular system. Additionally, patients experience symptoms of increased intracranial pressure such as headaches, dizziness, nausea, and dry heaves. Severe hydrocephalus can lead to significant increases in intracranial pressure, with patients suffering from severe headaches, dizziness, and even accompanied by papilledema, decreased vision, visual field defects, and optic atrophy. Furthermore, patients with hydrocephalus may exhibit significant cognitive dysfunction, characterized by reduced intelligence levels, diminished learning ability, computational skills, and memory loss. The physical motor functions of patients also gradually decline, presenting as unstable walking, a propensity to fall, and even possibly accompanied by urinary and fecal incontinence.