Early manifestations of infant hydrocephalus

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 06, 2024
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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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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.

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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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Hydrocephalus should be treated in the neurology department.

If you have hydrocephalus, it is recommended to visit the neurosurgery department at your local hospital and ask a neurosurgeon to assess your current condition. It is generally advised that patients undergo a cranial CT scan or MRI to determine the extent and severity of the hydrocephalus and to choose the appropriate treatment method. For static hydrocephalus, most patients do not exhibit clear clinical symptoms and generally do not require special treatment, regular monitoring is sufficient. For progressive hydrocephalus, surgical treatment is often necessary, and it is generally recommended that patients undergo ventriculoperitoneal shunt surgery. With surgical treatment, most patients can achieve satisfactory results.

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How to deal with hydrocephalus?

The treatment of hydrocephalus must clearly identify the severity of the condition. Hydrocephalus can be categorized into acute and chronic types. In cases of acute hydrocephalus, emergency ventricular puncture drainage surgery is required, otherwise, it may cause brain herniation leading to death. For chronic hydrocephalus, it is crucial to distinguish whether it is communicating hydrocephalus or obstructive hydrocephalus. For obstructive hydrocephalus, treatment options include creating a patency in the cerebral aqueduct and third ventriculostomy. For other types of hydrocephalus, ventriculoperitoneal shunt surgery can be performed. Therefore, it is essential to clearly determine the type of hydrocephalus to fundamentally select the appropriate surgical methods and instruments.

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Symptoms of hydrocephalus

For patients with hydrocephalus, it often leads to a series of symptoms and signs. For example, patients may experience mild cognitive impairments, manifesting as obvious memory loss, reduced intelligence, and weakened orientation ability in terms of time, space, and person recognition. In addition, most patients also suffer from motor dysfunction, showing symptoms like weakness in one or both legs, difficulty walking, unstable gait, and a tendency to fall. Some patients might even experience changes in emotion and personality. As the condition of cerebral hemorrhage gradually progresses, patients may exhibit symptoms of increased intracranial pressure.