hydrocephalus question

[HShearerRN2011, BSN, RN]

Why can't hydrocephalus be cured? My textbook really didn't cover the why and most of the internet searches don't either. I figured if you treat the underlying cause, such as infection or hemorrhage, then the ventricles could start reabsorbing the CSF or the flow could be restored throughout the ventricles. I did read that in some cases if the cause is a tumor, the hydrocephalus will resolve once the tumor is removed, but in any other case shunts or meds would be needed for lifelong treatment. Anybody know the patho for this? Any help is appreciated!!

[klone, MSN, RN]

It depends on WHY, but it can be cured sometimes. Sometimes a baby might be born with hydrocephalus and requires a shunt, and the shunt is only a temporary necessity.

[StL_Momma27]

My niece was born with hydrocephalus and she now has a shunt in her head. She also has a narrowing in her neck where the fluid flows in and out.

[Esme12, ASN, BSN, RN]

"Obstructive Hydrocephalus

Hydrocephalus is a condition in which an abnormal amount of cerebrospinal fluid accumulates in the brain. It is sometimes referred to as "water on the brain," and indeed the name "hydrocephalus" comes from the Greek words for water (hydro) and head (kephale). Cerebrospinal fluid, or CSF, is a clear, watery fluid that surrounds the brain and spinal cord. CSF serves many important functions. It cushions and protects the brain from injury; it delivers nutrients to nourish the brain; it removes waste from tissues; and it regulates pressure within the brain.

Normally, CSF is produced and continuously circulates in cavities called ventricles before being absorbed into the bloodstream. Obstructive hydrocephalus occurs when the passage of CSF is blocked. When this occurs, the fluid builds up inside the ventricle and causes pressure on adjacent brain tissue. Another kind of hydrocephalus, called non-obstructive or communicating hydrocephalus, occurs when the brain has trouble re-absorbing CSF or produces too much CSF. This article will review the common symptoms and treatment of obstructive hydrocephalus.

Causes

Hydrocephalus can occur at any age, but it is most common in infants and young children or in adults over the age of 60. According to the National Institute of Neurological Disorders and Stroke, hydrocephalus affects approximately one in every 500 children. Obstructive hydrocephalus can be a congenital condition, meaning it is present at birth. In these cases, it typically results from a genetic disorder such as spina bifida (a malformation of the spine), or as a complication of premature birth with brain hemorrhage. In other cases, the hydrocephalus is an acquired condition that develops later in life due to a brain tumor or cyst, head injury, or an infection such as meningitis.

Symptoms

The symptoms of hydrocephalus vary according to age and individual. Hydrocephalus can be more obvious in infants and toddlers because the bones of the skull are not yet closed, and the build-up of fluid can cause an enlarged head, a tense or bulging soft spot, a thin scalp, prominent veins in the scalp, or separated bones in the head. In addition, infants may suffer from symptoms such as vomiting, drowsiness, irritability, constant downward gaze, poor appetite, or seizures. The same symptoms may be present for toddlers and young children, along with headache, nausea, fever, delayed progress in walking or talking, poor coordination, inability to concentrate, or loss of sensory or motor functions. In older children and adults, the bones of the skill are closed together and the head cannot enlarge. Therefore, the symptoms of hydrocephalus reflect increased pressure on the brain. These symptoms may include headache, loss of coordination or balance, nausea, vomiting, bladder control problems, impaired vision, and changes in concentration or memory. "

http://emedicine.medscape.com/article/1135286-overview

or google it............

http://tinyurl.com/66l3xl7 :0)

[tralalaRN]

Back to your original question "why can't it be cured". . I have a daughter (former preemie) with a shunt secondary to a brain hemorrhage shortly after her birth. Also have an older sister who had congenital hydrocephalus.

One of the poster's above mentioned that in some cases, such as with a tumor, it can be cured. The tumor is removed, thereby removing the blockage from the pathway of the ventricals to the spinal cord. In cases such as with preemies or older adults with strokes, sometimes those pathways are so badly damaged by the stroke, that there is no chance of re-establishing circulation. So then a shunt is necessary to divert the fluid elsewhere so it doesn't build up inside of the cranium, causing pain, pressure and more damage.

Recently, there was something on the news about a new invention called "brain flushing" for preemies with brain hemorrhages to remove the blood from the brain and thereby hoping to minimize damage. Don't know if this can help to prevent the development of hydrocephalus, but sounds promising. Here is the link: http://www.timesonline.co.uk/tol/life_and_style/health/child_health/article7052517.ece

In the case of congenital hydrocephalus - my sister's did resolve on it's own, however, this is not typical, so perhaps in her case, there was some inflammation in the pathway that eventually resolved. She is in her 60s now, and was actually born prior to the invention of shunts. My parents were told to basically take her home and try to make her comfortable, and that she would be gone in a few months. She did develop schizophrenia as a young adult - something that seems to be more common in patients with enlarged ventricles.

Hope this helps.