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The word "hydrocephalus" is derived from the Greek "cephalus," meaning head and "hydro," referring to water. Within the normal human brain, there is a space called the ventricle that is filled with cerebrospinal fluid (CSF). CSF is produced in the ventricle and absorbed continuously. As the blood circulates through the blood vessels, cerebrospinal fluid circulates around the brain and the spinal cord. Hydrocephalus is an excessive accumulation of cerebrospinal fluid within the ventricle. The accumulated fluid compresses the brain tissue, causing brain damage and the dilatation of ventricle.
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The symptoms of hydrocephalus vary with age.
- In infants:
- Large head size
- Failure to Thrive
- Vomiting
- Seizures
- Irritability or lethargy
- In older children and adult
- Vomiting, nausea, and headaches
- Blurred vision due to optic nerve damage
- Delayed development
- Gait difficulty
- Problems with balance and coordination
- Urinary incontinence
- Intellectual dysfunction
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- The mechanisms of fluid accumulation
- Blockage of CSF circulation or absorption
- Excessive production of CSF
- Hydrocephalus may be congenital or acquired. The causes of hydrocephalus include tumors, hemorrhages or infections (meningitis, Encephalitis) and head trauma. Congenital hydrocephalus is often a part of other congenital malformations of the central nervous system, such as the neural tube defect, Chiari malformation, and Dandy-Walker syndrome, etc.
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- A Cranial ultrasonography exposes the enlarged ventricles that may exist in infants
- Brain computer tomography (CT) or Magnetic Resonance Imaging (MRI)
- Radionuclide cisternography (brain scan using radioisotope) shows the abnormal CSF flow and accumulation of CSF.
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The primary
treatment of hydrocephalus is the surgical placement of a
Shunt, a soft plastic tube is inserted to allow drainage of
the CSF into another part of the body (usually, abdomen),
therefore relieving the pressure on the brain. Certain types
of hydrocephalus can be treated by "ventriculostomy," an
operation where a tiny hole is made in the floor of the
ventricle to bypass the
obstruction.
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The prognosis depends on the underlying condition responsible for hydrocephalus and the timing of the diagnosis and treatment. Many people survive with proper treatment, but the permanent disability such as physical impairment, intellectual dysfunction and loss of vision can persist throughout a lifetime.
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