Hydrocephalus is defined as an excess of cerebrospinal fluid in the brain. This condition can occur at any age, but is most common in infants and adults age 60 and older. In the following article we focus specifically on explaining the causes and symptoms, among other things, of hydrocephalus in adults.
Cerebrospinal fluid serves a critical function. It helps protect the nervous system because it acts as a buffer from sudden impacts and prevents injuries to the brain or spinal cord. Generally speaking, it helps the body's most important system (the nervous system) function properly.
In a normal scenario, cerebrospinal fluid flows through the ventricles and after flowing around the brain and spinal cord is absorbed into the bloodstream. When there is an excessive build-up of this fluid, it causes an abnormal dilation of the spaces that contain it in the brain, known as ventricles. Such dilation causes pressure on brain tissue that is potentially harmful.
There has to be a balance between the production of liquid and its absorption, and when this balance is disturbed, it can give rise to hydrocephalus. Below, we indicate the main causes of this disease, its symptoms in adults, as well as its evolution and treatment.
Main causes of hydrocephalus
As we described above, this disease arises when the balance between the production and absorption of cerebrospinal fluid is disturbed. This is the primary cause of hydrocephalus. Excess fluid in the brain occurs for three reasons:
- Obstruction: An obstruction may impede the cerebrospinal fluid from passing correctly from one ventricle to another, or from the ventricles to the rest of the spaces that surround the brain.
- Poor absorption: This is a common occurrence. When it happens, it is usually related to inflammation of brain tissues due to disease or injury, for example after an infection or bleeding in the brain.
- Excess production: in very isolated cases, excess cerebrospinal fluid is produced as a result of a tumor, and it is also likely to be poorly absorbed by the bloodstream.
The causes of this pathology can vary depending on the type of hydrocephalus. In addition, there is congenital hydrocephalus, which occurs at the time of birth, but in some cases, is not diagnosed until later, as well as that which is acquired for other reasons, known as acquired hydrocephalus.
Causes of congenital hydrocephalus:
- Chiari malformations and/or myelomeningocele.
- Aqueductal stenosis, which causes an obstruction in the circulation of cerebrospinal fluid.
- Cerebellar, vascular or genetic malformations.
Causes of acquired hydrocephalus:
- After neurosurgery of the posterior fossa (cerebellum).
- Brain or spinal tumors.
- Subarachnoid or intraventricular hemorrhage, that is, bleeding in the brain.
- Meningitis or other brain infections.
- Idiopathic hydrocephalus at normal adult pressure.
Find out more about hydrocephalus
Hydrocephalus in adults: most common symptoms
The main symptoms of hydrocephalus in adults are as follows:
- Dementia: altered speech, slowing of thought, memory loss.
- Impaired ability to walk (gait disorders): short steps, wide base, feeling of having your feet stuck to the ground, difficulty starting to walk or turn.
- Urinary incontinence.
- Excess fatigue, lack of motivation, apathy, daytime sleepiness.
- If the cause is acute or subacute, headache, nausea, visual problems, decreased level of consciousness.
Sometimes the patient may mistake these symptoms as symptoms of some other disease, and for that reason, delays consulting a specialist. That delay can be critical, because as symptoms worsen the disease evolves and, therefore, the patient's abilities to perform tasks at home or at work may begin to be affected.
Having these symptoms is not necessarily cause for alarm, because they can indeed be caused by other diseases that do not affect the health of your brain. The only way to be sure is to go see a doctor.
Some of the diseases that may be mistaken for hydrocephalus are Alzheimer's disease, Parkinson's, cervical myelopathy or thyroid hormone deficiency, among others.
Keep in mind that there are no diseases in patients, but patients with diseases. Why do we say this? Because we want you to understand that the severity of symptoms and their effects can vary from person to person. Our experience confirms that patients can manifest the same disease differently.
In some cases, hydrocephalus can be asymptomatic, and in others, the symptoms have occurred for years, without causing drastic changes in the patient’s life, until he ends up developing a severe disability as a result of the lack of an early diagnosis. So it is important that you check with your doctor when you notice any change in your health.
Meet Dr. Montes: one of the doctors who treats hydrocephalus at Instituto Clave
Treatment of hydrocephalus in adults
The main objectives of the various treatments for hydrocephalus in adults is to improve symptoms. The specialist will try to divert the cerebrospinal fluid to return it to its natural circulation. The most common treatments are described below:
- Ventriculoperitoneal VP shunt surgery: This involves surgically inserting a drainage system. The surgeon inserts a catheter (a tube), composed of a valve, which will have the function of keeping the fluid of the brain flowing in the right direction and at the right speed.
Through this shunt, placed in the ventricle, the cerebrospinal fluid can be diverted to other parts of the body, such as the abdominal cavity or the heart, places where the cerebrospinal fluid is absorbed. -
Ventriculostomy: During this procedure, the surgeon uses a small video camera to get a direct view of the inside of the brain and makes a small hole in the bottom of one of the ventricles, or between the ventricles, to allow cerebrospinal fluid to flow properly. This is a procedure that cannot be performed on all patients.
If you need more information, don’t hesitate to contact our specialists
Categories: Brain treatments, Brain pathologies, Instituto Clavel