Hydrocephalus- Causes, Symptoms and Prevention

Roona Begum

It was heartbreaking reading up a story, five months ago, in dailymail about Roona Begum- a three-year-old hydrocephalus patient. In three years, Baby Roona, as reported by dailymail, smiled for the first time after a successful surgery to reduce the size of her head. Looking at the smiling face of this pure soul I was torn in-between smiling with her and weeping at the condition she found herself.

Then again on the 6^th of September, Angels carried Ndubuisi Nwachukwu Ibiam away while he was enjoying the warmth comfort of his mother.

I could still picture that day like the reflection of my face in a mirror on how my heart was literary torn into shreds by grief when news reached me that Baby Miracle, as he was fondly called, had left our world as pure and innocent as he had come.

Baby Miracle was an angel who struggled with congenital hydrocephalus for 2years and 3months and when all the efforts by his parents, good spirited individuals and the Indian surgeons failed to save him...he...left us in tears.

It was awfully sad but our solace is that he is happier now.

This is just two out of many registered cases of hydrocephalus. While some have survived it and lived a normal and happy life ever after, others have not been favoured with such luck.

Hydrocephalus

Hydrocephalus- a condition common among infants and the aged, is derived from two Greek words; Hydro (water) and Cephalus (head) which literary translates to water on the head.

This is a condition which arises from the super abundance of cerebrospinal fluid (CSF) in the ventricles of the brain leading to increased head pressure. It causes an abnormal increase of head size in newborns or infants.

Types of Hydrocephalus

There are basically two types of hydrocephalus:

1. Congenital hydrocephalus 
2.  Acquired hydrocephalus

Congenital hydrocephalus as the name implies is when a child develops the condition in the womb and is born with it. This could be as a result of genetic defects, neural tube defects including spina bifida or certain infections during pregnancy.

Acquired hydrocephalus on the other hand occurs during delivery or much later in the child’s life and it is as a result of complications following premature delivery (especially bleeding in the brain), brain tumour, severe head injuries, and infections of the brain and spinal cord. This type affects children, adults and older people.

Symptoms of hydrocephalus

The early detection of hydrocephalus is necessary for the immediate commencement of treatment. The symptoms vary according to the age of a patient.

In congenital hydrocephalus, there’s a significant increase in head size with visible swollen veins. This is so because the head of the infant have not yet strengthened and so would continue to expand to enable it accommodate the excess CSF.  Other symptoms are drowsiness, elevated temperature, irritability, problem with breathing, convulsion, frequent vomiting and peripheral vision loss.

For older children and the aged:

1. Because the skull has hardened at this stage, the patient would not experience any abnormal increase in head size but a severe, throbbing headache. 
2. The patient would have difficulties walking, talking and eating without assistance.
3. The patient may experience memory loss 
4.  Hazy vision which may affect both eyes
5. Bladder control becomes difficult 
6. Diplopia and strabismus 
7. The person may also experience nausea, excessive sleepiness, seizure and vomiting.

How does hydrocephalus develop?

Cerebrospinal fluid (CSF) is a colourless liquid produced mainly in the choroidplexus and stored in the ventricles of the brain. This liquid normally surrounds the brain and the spinal cord and protects them from injuries. It also supplies them with nutrients and serves the function of flushing out waste products through the blood stream.

In a day, the brain produces approximately 500ml of this liquid but not all of this quantity is left in the brain. It is continuously reabsorbed until only about 100-160ml is left at a time.

If a situation arises where any of the four ventricles are blocked or an unwanted amount of CSF could not be drained away from the brain, the liquid would continue to accumulate and eventually lead to hydrocephalus.

Prevention/Treatment

Though congenital hydrocephalus cannot be entirely avoided but certain actions could be taken in advance, especially by expectant mothers to reduce the risk of their foetus developing this condition.

• Maintain a proper hygiene and eat healthy while pregnant. Eat lots of fruits and vegetable. Okra and other vegetables have been found to contain folate which is necessary to prevent neural tube defects- a medical condition which could also predispose a child in the womb to congenital hydrocephalus. Always ensure that the fruits and vegetables are properly washed. 
• Guard yourself and your baby against head injuries. Be safety conscious and make sure your baby is not in any position where he or she could fall accidentally and crash his or her head.
• Infectious diseases like chickenpox and meningitis could increase a child’s risk of hydrocephalus. Always ensure your baby gets all the recommended vaccines. 
•  Premature labour and certain infections during pregnancy could predispose a foetus to hydrocephalus. This is why you should take prenatal care seriously. Always check up with your doctor to know how your pregnancy is coming on and make sure you promptly report any funny feeling to him for immediate medical investigation. 
• Quit smoking and consume less of alcohol during pregnancy. Exercise as often as you can but make sure you confirm with your doctor on the exercise routine best for you.

Treatment

The prompt treatment of hydrocephalus is needed to avert complications and deaths. A child treated of hydrocephalus on time could go on living a normal life with fewer limitations.

Treatment usually involves surgically inserting a shunt in the brain to drain the excess CSF.

 Antibiotics may also be administered if the need arises but quickly see a doctor when your child shows the aforementioned symptoms of this medical condition.

photo credit: mirror.co.uk