Hydrocephalus

Hydrocephalus literally means “water on the brain” and refers to conditions where there is an abnormal amount of cerebrospinal fluid (CSF) in or around the brain. About 750ml of CSF is produced by the brain each day.

Hydrocephalus is usually caused by a blockage in the system, preventing CSF from either flowing around the brain, or from draining back into the blood stream.

  • Causes: The blockage of hydrocephalus can be caused by many conditions, including brain tumours, subarachnoid haemorrhage (due to ruptured aneurysm or AVM), infection (including meningitis), brain trauma or congenital conditions such as aqueduct stenosis or Chiari malformation/spina bifida
  • Symptoms: Symptoms of hydrocephalus can include headache, nausea, vomiting, blurred vision, poor balance, difficulty walking, and changes in mood or behaviour.
  • Diagnosis: Hydrocephalus is usually diagnosed through imaging tests, such as CT scans or MRI, and sometimes a lumbar puncture may be needed.
  • Treatment: The treatment for hydrocephalus is to drain CSF or bypass the CSF blockage. This may require insertion of a permanent drain system (ventriculoperitoneal shunt) to drain the fluid. A small silicon tube is inserted into the fluid space in the brain via a small hole in the skull, connected to a valve and then tracked under the skin across the chest and abdomen to be placed into the abdominal space, where the fluid drains around the stomach and intestines. Occasionally, a direct hole can be made in the brain with a camera to bypass a blockage and avoid the need for a permanent shunt. This is called an endoscopic third ventriculostomy.
  • Prognosis: The prognosis for patients with hydrocephalus varies depending on the cause and severity of the condition, as well as the age and overall health of the patient.

It’s important to discuss the potential risks and benefits of a craniotomy with your doctor to make an informed decision about treatment. Regular follow-up care is also important to monitor progress and change the treatment plan if necessary.

Normal Pressure Hydrocephalus

Normal Pressure Hydrocephalus is a specific type of hydrocephalus. In this syndrome, known as NPH, patients complain of trouble walking, unsteadiness, short term memory problems, dementia and urinary incontinence. The exact cause is unknown, but NPH affects people in their 70’s or 80’s. Diagnosis will include MRI scans and sometimes a lumbar puncture (spinal tap) and physiotherapy assessment. The treatment is generally with a ventriculoperitoneal shunt. A programmable shunt is often used so your doctor can change the draining pressure of the shunt with a small magnet on the skin, to personalise your treatment.