Can fetal hydrocephalus be kept?

Written by Gao Yi Shen
Neurosurgery
Updated on December 31, 2024
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Whether fetal hydrocephalus should result in termination must be determined based on a specific analysis of the particular medical condition at that time. Fetal hydrocephalus is merely a manifestation of an illness. It is essential to understand the root cause of the hydrocephalus to make a clear decision regarding the options available. If the hydrocephalus is combined with cranial malformations or abnormalities in the cerebral gyri and sulci or other congenital development defects, in general, such conditions are not survivable even into adulthood. There is no possibility of survival, and even if surgery is performed later, it cannot provide an effective treatment. However, in cases where conditions such as spina bifida occur, with active surgical intervention, these can have a very positive prognosis. Therefore, it is crucial to clearly identify the specific medical condition at the time to determine the most appropriate course of action.

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Written by Gao Yi Shen
Neurosurgery
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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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Written by Chen Yu Fei
Neurosurgery
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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.

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Written by Chen Yu Fei
Neurosurgery
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How to alleviate pain from hydrocephalus?

For patients with hydrocephalus, if there is significant pain, it is mostly caused by increased intracranial pressure, often seen in progressive hydrocephalus, or obstructive hydrocephalus. As the cerebrospinal fluid gradually increases and accumulates, it leads to the expansion of the ventricular system and causes extensive hydrocephalus, accompanied by gradually increasing intracranial pressure. To alleviate the pain, one might consider taking oral long-acting analgesics to help relieve the pain. Additionally, the use of mannitol or performing a lumbar puncture to release a small amount of cerebrospinal fluid may be considered to ease the pain. However, the key is to achieve the ultimate resolution of the disease through surgery.

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Written by Chen Yu Fei
Neurosurgery
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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.

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Written by Jiang Fang Shuai
Neurosurgery
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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.