My church member has a condition that necessitates a sort of shunt in his brain. I believe it is called hydrocephalus. What is this condition?
Hydrocephalus is a condition that happens when there is a build-up of cerebrospinal fluid in your brain’s ventricles.
It can happen at any age, from baby to adult.
What are the brain’s ventricles?
Ventricles are spaces or cavities in your brain.
They are connected to one another.
There are four of them altogether: left, right, third and fourth.
The left ventricle is located on the left side of your cerebral hemisphere.
Likewise, the right ventricle is on the right side of your brain.
The left and right ventricles are also known as the lateral ventricles.
They have “horns” that go into your frontal, temporal and occipital lobes.
As you age, these ventricles increase in size.
The lateral ventricles are connected to your third ventricle by a passage called the foramen of Monro.
The third ventricle is in between your right and left thalamus, which is a major relay system in your brain for communications between your different body parts.
The third ventricle is connected to your fourth ventricle via the cerebal aqueduct.
This fourth ventricle is situated within your brainstem.
It connects and drains into the central spinal canal of your spinal cord and the subarachnoid cisterns that bathe your brain.
The ventricles are in charge of producing your cerebrospinal fluid, as well as transporting and removing it.
What is this cerebrospinal fluid?
Cerebrospinal fluid is the clear, watery fluid that bathes your entire central nervous system, i.e. your brain and spinal cord.
It is very important because it buffers any physical shock to your brain and spinal cord, especially if you make sudden movements or suffer from sudden impact or injuries.
It supports your brain’s weight like a nice waterbed to prevent it from being crushed against your hard skull.
It is also very important in maintaining a normal intracranial pressure within your brain.
It delivers nutrients to your brain and spinal cord, and also removes waste.
How is this all related to hydrocephalus?
In a nutshell, hydrocephalus occurs when there is a build-up of too much cerebrospinal fluid in your ventricles.
As we are talking about adult hydrocephalus, we have to understand that it is very different from the type of hydrocephalus that happens in childhood.
In children, the skull bones are not yet fixed because they are still growing.
So the skull allows enlargement of the head if there is an over-accumulation of cerebrospinal fluid.
That is why in children with hydrocephalus, you can get head enlargement or bulging fontanelles (the soft areas between a child’s skull bones).
This is not a good thing as childhood hydrocephalus can lead to delay in the child achieving their developmental milestones.
But in adults, the skull bones have fused; there is no space to accommodate excess cerebrospinal fluid.
What causes hydrocephalus in adults then?
There are several causes:
> Congenital, but only diagnosed as an adult
There are some cases of hydrocephalus in childhood that did not manifest until they became adults.
It is not fully clear why some people, or their caregivers, never noticed they had this condition during childhood.
Maybe they had symptoms that were mistaken for something else.
Many people discover they have adult hydrocephalus when they have a CT (computed tomography) scan for something else, such as a headache.
Childhood hydrocephalus can be caused by brain malformations, aqueduct blockage or spina bifida.
> Acquired
This is the type of hydrocephalus that develops any time after you are born.
It can be caused by head injuries, bleeding in your brain, brain tumours, or infections of your brain and spinal cord, such as meningitis or encephalitis.
> Normal pressure hydrocephalus
This usually occurs in adults over 60 years of age.
In this type, the ventricles enlarge inside the brain, but there is no increase in the pressure inside the ventricles.
There are also children who were diagnosed with hydrocephalus, were successfully treated and have grown up into adults with their condition.
How would I know if I have hydrocephalus as an adult?
Hydrocephalus can present with a wide array of symptoms because of the increased pressure in your ventricles pushing against your brain matter.
What you will experience depends on the part of the brain that is impacted.
Symptoms can include:
- Headaches that can be severe and last a long time
- Nausea and vomiting
- Extreme fatigue
- Fainting
- Double vision and/or blurred vision (if the back/occipital lobe is impacted)
- Difficulty with decision-making, memory and judgment (if the cortex is impacted)
- Coordination and balance problems, and trouble walking (if the cerebellum is impacted)
- Hearing loss.
You may also experience no symptoms whatsoever.
Regardless of symptoms, a CT scan should be able to pick hydrocephalus up.
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.