Hydrocephalus in children: causes, diagnosis and treatment

Hydrocephalus in children is an excessive accumulation of cerebrospinal fluid ( cerebrospinal fluid ) in the brain cavities (ventricles). CSF is produced in the vascular plexuses of the ventricles, circulates through the brain and spinal cord, where it is reabsorbed. When this path is blocked for any reason, it accumulates, and hydrocephalus develops. CSF has many important functions: nutrition of the brain, softening, protection of nerve tissue and waste disposal.

Causes

Congenital hydrocephalus in children is due to the complex interaction of genetic and environmental factors. Aqueductal stenosis of the thin canal (constriction) is the most common cause. There may also be a blockage of the fourth ventricle (Dandy-Walker syndrome) or Chiari anomaly and other causes.

Acquired hydrocephalus in children: can result from infection, bleeding (bleeding), head trauma, swelling and cyst. The most common cause is meningitis.

Diagnostics

Hydrocephalus in children (the photo you see in this article) can be detected by observing the behavior of the child and in the presence of some physical signs. For example, a small child has a bad appetite, frequent crying, excessive drowsiness, an increase in the circumference of the head at the top, inability to move the eyes upwards and vomiting will indicate a problem. A child older than the first signs may be lethargy, irritability and decline in school performance.

Confirm or refute the diagnosis is possible by going through ultrasound (ultrasound), computed tomography (CT) or magnetic resonance imaging (MRI). In the presence of hydrocephalus, these techniques will show the degree of ventricular expansion, the site of blockage and the cause (s).

Treatment of hydrocephalus

Unfortunately, modern medicine does not know how to prevent this serious disease. The method of treatment depends on the cause of the disease. For example, if the obstruction is in a thin canal due to a tumor or cyst, it can be surgically removed to restore CSF circulation. In other situations, the most effective method of treatment is the introduction of a shunt (with a known pressure gradient). The shunt is a hollow silicone tube that is placed in the ventricular system, directing the flow of liquor into the abdominal cavity of the abdomen. If it can not absorb liquid due to some diseases (for example, cysts), then the shunt can be placed through the jugular vein into the right atrium. Shunts can also be located in the pleural cavity.

How long does the shunt last? If it is not blocked or not infected, then it does not cause any problems by itself and can remain in place for many years. Only if the surgeon is sure that it is unsafe, it can be removed. However, in many cases, the shunt remains for life, without causing any problems.

Endoscopic treatment can be used to create alternative pathways for cerebrospinal fluid, with no need for shunting. These methods are still under development, but they can find wide application in the future.

In most cases, the procedures performed successfully control hydrocephalus. Many children have normal intelligence and development. They can only be a little inhibited in the process of learning or acquiring coordination.