The medical diagnosis hydrocephalus is a condition where patients have an excess of cerebrospinal fluid (CSF) in the brain. While this condition can affect patients of all ages – from newborns to the elderly – there are different kinds of hydrocephalus.
“Unlike other health conditions, there aren’t always clear pre-existing health markers or risk factors that can increase your chances of hydrocephalus,” says Pouya Entezami, M.D., a neurosurgeon at Henry Ford Health. “Since this can happen to anyone, it takes a high index of suspicion from your provider to identify it, and it can often be missed.”
Here, Dr. Entezami explains factors that can contribute to hydrocephalus and how this condition affects patients of different ages.
How Hydrocephalus Can Develop
Your body has 125 to 150 milliliters of spinal fluid that protects the brain and spinal cord, bathing these important structures in this specialized fluid. Cerebrospinal fluid has many functions including acting as a protective cushion for the brain, providing nutrients, and clearing away waste products. Your body produces roughly half a liter of spinal fluid each day – naturally replenishing the body’s store of the fluid and allowing older fluid to be reabsorbed.
“If everything is functioning correctly, the volume of spinal fluid in your body should stay roughly the same each day,” says Dr. Entezami. “When the body isn’t able to reabsorb this fluid, the regular production of spinal fluid can lead to an increase of fluid in the brain ventricles – the specialized cavities that store this fluid as its produced.”
There are several reasons hydrocephalus may occur. Excess fluid in the brain can be the result of:
- Traumatic brain injuries
- Tumors or cancer
- Stroke
- Brain swelling
- Infections
- Blockages along the drainage pathway
- Excess spinal fluid production
- Congenital problems (something you are born with)
- Idiopathic causes (meaning specialists don’t know why it’s happening)
How Hydrocephalus Affects People By Age
Depending on your age, the symptoms of hydrocephalus may present differently:
In infants:
When babies are born, the bones of their skull aren’t fused together yet. Congenital hydrocephalus can cause their head to increase in size beyond the normal growth curve and the soft spot on the crown of their head to bulge out. In some cases, hydrocephalus is diagnosed before a baby is born. Pediatricians are quite skilled at looking for any signs of hydrocephalus during the initial post-birth visits.
In children:
For children with hydrocephalus, they may develop headaches or be found to have developmental delays during their well-visit appointments. In rare cases, a brain tumor may be the cause, but fear not. Dr. Entezami notes that children are often the easiest to diagnose as they have regular checkups with their pediatrician, but an ultrasound or MRI is often needed to diagnose.
In adults:
Patients often report issues focusing, headaches or vision changes. These vision changes and headaches may become more regular as the hydrocephalus progresses. Be sure to report symptoms to your primary care provider as they will be able to help narrow down a diagnosis and refer you to the appropriate care team as there are much more common diseases that cause these symptoms as well.
In seniors:
Aging patients can develop an idiopathic form of hydrocephalus known as Normal Pressure Hydrocephalus (NPH). Symptoms include walking and mobility issues, memory changes, and incontinence. Because many of these symptoms are associated with other neurological conditions that affect aging populations (such as Alzheimer’s dementia), hydrocephalus can be difficult to diagnose properly.
Diagnosing And Treating Hydrocephalus
NPH Clinic At Henry Ford
In many cases, hydrocephalus is straightforward enough for your provider to diagnose with a clinical exam and review of your medical history. Other methods of confirming the diagnosis may include a CT or MRI scan, or a lumbar puncture in the spine to measure the elevated pressure levels of your spinal fluid.
Dr. Entezami also notes that keeping up with regular eye exams is important for younger patients as sudden vision changes may be a symptom of fluid buildup. This is something your eye doctor would be able to flag.
Once diagnosed, your provider will refer you to a neurosurgeon. After determining the type of hydrocephalus you are dealing with and the cause of the fluid buildup, they will help direct you for treatment. Neurosurgeons, neurologists, headache specialists, ophthalmologists, and of course, your primary care physician may be involved with treating your hydrocephalus depending on the factors contributing to the fluid buildup.
“At this time, brain surgery is the most common way to correct hydrocephalus,” says Dr. Entezami. “Your surgeon will perform a procedure that helps route the excess spinal fluid away from the brain so it can be absorbed in another part of the body, either by creating new channels within the brain or routing the fluid to the stomach using tubing. However, Henry Ford is involved in several research studies and an exciting new trial on hydrocephalus.”
Due to the complexity of this surgery, not all patients are good candidates for treatment. But, with ongoing clinical trials exploring newer options in treating hydrocephalus, treatment could become more available to more patients in a more minimally invasive fashion in the future.
Reviewed by Dr. Pouya Entezami, a neurosurgeon who sees patients at Henry Ford Medical - Lakeside, Henry Ford West Bloomfield Hospital and Henry Ford West Bloomfield Hospital Clinics.
