The brain produces the cerebrospinal fluid and stores a significant volume of fluid. It is held within compartments of the brain referred to as ventricles. Hydrocephalus is a condition where there is excess fluid within the ventricles. It is sometimes referred to as having fluid on the brain.
The normal human brain contains cerebrospinal fluid. The clear and colourless fluid circulates through the brain and spine. It main function is to carry nutrients as well as waste products through the brain and spine. It is sometimes referred to as a window to the brain. Removing this fluid and testing it is a common method for diagnosing brain and spine conditions.
This condition can occur in children or in adults. Increased retention of cerebrospinal fluid in the brain leads to increased pressure in the skull. This can cause further damage to the brain tissue. The skull of infants and children is not as rigid. Hydrocephalus can result in the expansion of children’s skulls. In adults, hydrocephalus results in raised intracranial pressure.
The most common symptoms of hydrocephalus are:
- vision problems
- difficulty walking
A sequence of MRI scans can diagnose hydrocephalus. This includes an ophthalmological evaluation. Sometimes further invasive techniques are employed to measure the pressure inside the brain.
The definitive treatment of hydrocephalus is performing a shunt operation or endoscopic ventriculostomy. This involves putting a tube into the ventricles of the brain. Then the distal end of the tube channels fluid under the skin and into the abdomen. In this manner, excess fluid is drained, alleviating pressure and preventing any damage to the brain. It may be preferable to use a programmable shunt which is also MRI compatible. It is not unusual to make adjustments to the shunt valve settings to control and regulate CSF drainage.
Normal Pressure Hydrocephalus
A subset of hydrocephalus, referred to as normal pressure hydrocephalus, occurs in the elderly. This usually exhibits a triad of symptoms:
- a walking imbalance
- memory impairment
- difficulty controlling urination
Clinical presentation of this condition varies. MRI scans can show dilated ventricular chambers. However, this can also occur in older patients with age related brain atrophy. Therefore, confirmatory tests for this condition are not definitive.
Diagnosis methods used are a cerebrospinal fluid tap test and intra cranial pressure monitoring tests.
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