Hydrocephalus is the accumulation of excess cerebrospinal fluid in the brain. Normally, this fluid functions to protect and provide nutrition to the brain. But when it accumulates excessively it can put high and dangerous pressure on the brain.
REASON
Hydrocephalus can be a congenital condition. Causes include genetic disorders and problems in fetal development due to malnutrition or infection during pregnancy. The most common infections include cytomegalovirus (CMV), rubella, mumps, syphilis, or toxoplasma. While the problem of malnutrition in the form of folic acid deficiency. Some types of congenital abnormalities that often occur include:
- Spina Bifida.
- Dandy Walker Syndrome and variants.
- Sylvian aqueduct stenosis.
Hydrocephalus can also occur after birth or in adulthood. This is known as acquired hydrocephalus, causes can include:
- Head injury.
- Strokes.
- Infection
- Tumor
SYMPTOM
Symptoms of congenital hydrocephalus are very typical, namely an enlarged head. This can occur in babies due to the sutures (brain joints) not being fused before the age of 18 months, so that high pressure on the head causes the head to enlarge. However, this usually occurs at an advanced stage, in the early stages it can be in the form of a convex fontanel. Meanwhile, in acquired hydrocephalus, symptoms include high pressure in the brain, including:
- Headache.
- Vomiting and nausea.
- Blurred vision.
- Balance problem.
- Bladder control problems.
- Thinking and memory problems.
TREATMENT
Hydrocephalus can permanently damage the brain, causing problems with physical and mental development. If left untreated, it is usually fatal. With the right treatment, patients can lead normal lives with few limitations.
- Treatment usually involves surgery to insert a shunt . The shunt is a flexible but sturdy plastic tube. The shunt moves cerebrospinal fluid to another area of the body where it can be permanently absorbed.
- Another therapy is a ventriculostomy, the procedure is almost the same as a shunt , but without installing a permanent device, only with a tube coming out of the head to temporarily drain cerebrospinal fluid. Or by using an endoscope to connect the fluid cavities in the brain.
DIAGNOSIS
Definitive diagnosis of hydrocephalus can use:
- Computed Tomography (CT)
- Magnetic Resonance Imaging (MRI)
- Ultrasound , only used when CT or MRI is not available, or it can be used as a screening while the baby is still in the womb.
PREVENTION
Prevention of congenital hydrocephalus begins in pregnancy. Pregnant women must carry out periodic controls so that if there is a viral infection, it can be identified and treated immediately. Ensure that pregnant women, infants and children receive complete immunizations according to the government's schedule. Several causes of hydrocephalus such as rubella infection, inflammation of the lining of the brain, and inflammation of the brain can be prevented by immunization. Meanwhile, acquired hydrocephalus can be overcome by treating the main cause.
Article written by dr. I Gde Anom Ananta, Sp.BS (Neurosurgeon Specialist at EMC Hospital Tangerang).