July 26, 2016 | Drew Anderson Photo source: Brain and Spine Foundation People born with spina bifida frequently also have hydrocephalus, however an individual may have hydrocephalus without having spina bifida. Hydrocephalus is a condition in which normal cerebrospinal fluid (CSF) circulation patterns are interrupted. The two most common causes of this are accidents and birth defects; however hydrocephalus can also occur as a result of brain tumors, cysts, scarring, infection, drug reactions and as a part of the aging process. It can be controlled by the surgical insertion of a shunt (a long, flexible tube with a one way valve that drains excess fluid to an area in the body where it can be absorbed). Who can have Hydrocephalus? Anyone can develop hydrocephalus throughout their life. Babies may be born with hydrocephalus or can develop it after birth as a result of congenital defect, children, teenagers and middle-aged adults can develop acquired hydrocephalus due to a stroke, tumor growth, meningitis, brain injury or other similar factors. Seniors can develop adult onset hydrocephalus and can take on two different forms, high intracranial pressure or normal pressure hydrocephalus. What are the symptoms of Hydrocephalus? Infants: • head enlargement • soft spot bulging when baby is upright and quiet • prominent scalp veins appear unnatually full • fever • vomiting • irritability • sleepiness • sunset eyes • seizures Toddlers: • head enlargement caused by enlarged ventricles • vomiting • irritability and tiredness • visual disturbances (blurred or double vision) • loss of previous cognitive or motor abilities, delayed development in walking and talking, or poor coordination or balance • seizures • lethargy or listlessness or sleepiness • bowel and bladder incontinence • change in personality or unable to concentrate Older Children: • headache • vomiting • visual disturbances (blurred or double vision) • personality change • loss of coordination or balance • seizures • tiredness or difficulty staying awake • difficulty waking up from sleep • irritability • incontinence • impairment of mental or motor performance • decline in academic or work performance Young and Middle-aged Adults: • chronic headaches • incontinence • headache unrelieved by pain medication • visual disturbances, fainting • gait disturbances; clumsiness, difficulty walking on uneven surfaces and stairs • cognitive problems: dependent on lists, decline in academic or work performance How is Hydrocephalus treated? Photo Source: Medioxy Health Services Hydrocephalus is usually treated by implanting a shunt surgically, that takes away the excess cerebrospinal fluid from the brain and drains it into another part of the body. There are many different types of shunts but the most common ones are: Ventro-peritoneal (VP) : The most commonly used shunt which diverts the fluid into the abdominal cavity, where it is reabsorbed by the membrane lining the stomach and intestines. Ventriculo-atrial (VA) : This shunt has the catheter in a vein leading to the right atrium of the heart which carries the CSF from the ventricles into the bloodstream. Lumbar-peritoneal (LP) : This shunt drains from the bottom of the spine into the peritoneal cavity. A shunt usually only consists of three parts: The Ventricular catheter , which is a small tube that leads from one of the ventricles, through a region of the brain where it will least affect the individual’s natural abilities. The Valve is a device that controls how CSF flows throughout the shunt, often including a reservoir set against the skull, under the skin. Distal catheter is a long thin, flexible tube that is attached to the valve and placed under the skin. It is important to recognize when the shunt is malfunctioning or is experiencing a blockage or infection. Shunt blockage may be caused by the blocking of tissue, blood cells or bacteria growths. It could also be blocked if parts of the shunt separate or if the position of the shunt changes. Obstruction of any sort will produce signs and symptoms of increased pressure in the head. Partial obstruction could result in occasional headaches, nausea, vomiting, drowsiness, listlessness and decreased mental function. Infection usually happens due to bacteria found normally on the skin, and occurs in 8 to 12% of all shunt surgeries. The shunt may get infected up to six months after surgery. Infections of the shunt can be life threatening and must be treated right away to reduce the risk of brain damage or death. Symptoms to look out for in a proximal catheter-end infection: headache fever swelling or redness along the shunt tract irritability meningitis stiff neck Symptoms to look out for in a peritoneal catheter-end infection: mild to moderate abdominal pain fever change in bowel habits listlessness abdominal swelling If any of these symptoms are occurring, you must seek medical attention immediately. Shunt infections are treated through surgically removing the infected shunt, the placement of a temporary external shunt, antibiotics to heal the infection and the surgical placement of a new shunt.