Can hydrocephalus heal itself?

Written by Chen Yu Fei
Neurosurgery
Updated on December 17, 2024
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Hydrocephalus often does not heal on its own and is generally classified into different types, such as symptomatic hydrocephalus and asymptomatic hydrocephalus, obstructive hydrocephalus and non-obstructive hydrocephalus, communicating hydrocephalus, and non-communicating hydrocephalus, among others. Relatively speaking, patients with obstructive symptomatic hydrocephalus usually exhibit a progressively worsening condition. Without timely and effective treatment, patients may experience significant headaches, dizziness, nausea, vomiting, accompanied by motor dysfunction, difficulty walking, urinary and fecal incontinence, and other clinical manifestations. For these patients, early surgical intervention is advisable, as they often cannot heal on their own, and their condition will progressively worsen.

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Will hydrocephalus cause the fontanel to bulge?

Hydrocephalus comes in two types: obstructive hydrocephalus and communicating hydrocephalus. Obstructive hydrocephalus is characterized by the inability of cerebrospinal fluid (CSF) to flow from the brain to the spinal cord, preventing normal circulation. In this situation, the pressure inside the skull can gradually increase due to the buildup of fluid, potentially leading to the progressive bulging of a child's fontanel. On the other hand, communicating hydrocephalus involves the CSF being able to circulate between the brain cavities and the spinal cord, merely resulting in an enlargement of the ventricles without the bulging of the fontanel.

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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.

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Can hydrocephalus be effectively treated?

For patients with hydrocephalus, if timely and effective treatment can be obtained, most patients can achieve very good treatment results. For patients with progressive obstructive hydrocephalus, it is especially important to seize the time to perform surgical treatment in the early stages. Clinically, it is generally recommended to choose ventriculoperitoneal shunt surgery, placing a drainage tube in the patient's lateral ventricle, entering the peritoneal cavity through a subcutaneous tunnel, and draining the cerebrospinal fluid from the ventricle to the peritoneal cavity, thereby achieving the purpose of relieving the excessive cerebrospinal fluid in the ventricular system. After undergoing surgery, the patient's dilated bilateral lateral ventricles can effectively shrink, and conditions such as pre-existing cognitive dysfunction, limb motor dysfunction, and incontinence will improve.

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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?

For patients with hydrocephalus, it is generally recommended to treat the condition surgically. Before the surgery, the patient should undergo a cranial CT or MRI to assess the type and severity of the hydrocephalus. If possible, a lumbar puncture should also be performed before the surgery to determine whether there is a significant increase in intracranial pressure, and a small amount of cerebrospinal fluid should be collected for routine and biochemical analysis of the cerebrospinal fluid. If there are no obvious contraindications to surgery, clinically, it is generally recommended to choose a ventriculoperitoneal shunt surgery. Most patients respond well to the surgery, and the morphology of the ventricular system gradually returns to normal.