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Concept
Hydrocephalus
Summary
Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain. This typically causes increased pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and downward pointing of the eyes.
Hydrocephalus can occur due to birth defects or be acquired later in life. Associated birth defects include neural tube defects and those that result in aqueductal stenosis. Other causes include meningitis, brain tumors, traumatic brain injury, intraventricular hemorrhage, and subarachnoid hemorrhage. The four types of hydrocephalus are communicating, noncommunicating, ex vacuo, and normal pressure. Diagnosis is typically made by physical examination and medical imaging.
Hydrocephalus is typically treated by the surgical placement of a shunt system. A procedure called a third ventriculostomy is an option in some people. Complications from shunts may include overdrainage, underdrainage, mechanical failure, infection, or obstruction. This may require replacement. Outcomes are variable, but many people with shunts live normal lives. Without treatment, permanent disability or death may occur.
About one to two per 1,000 newborns have hydrocephalus. Rates in the developing world may be higher. Normal pressure hydrocephalus is estimated to affect about 5 per 100,000 people, with rates increasing with age. Description of hydrocephalus by Hippocrates dates back more than 2,000 years. The word hydrocephalus is from the Greek , meaning 'water' and , meaning 'head'.
The clinical presentation of hydrocephalus varies with chronicity. Acute dilatation of the ventricular system is more likely to manifest with the nonspecific signs and symptoms of increased intracranial pressure (ICP). By contrast, chronic dilatation (especially in the elderly population) may have a more insidious onset presenting, for instance, with Hakim's triad (Adams' triad).
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Ontological neighbourhood
Related publications (25)
Related concepts (30)
Meningitis
Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, nausea, vomiting, and an inability to tolerate light or loud noises. Young children often exhibit only nonspecific symptoms, such as irritability, drowsiness, or poor feeding. A non-blanching rash (a rash that does not fade when a glass is rolled over it) may also be present.
Cerebral arteriovenous malformation
A cerebral arteriovenous malformation (cerebral AVM, CAVM, cAVM, brain AVM, or BAVM) is an abnormal connection between the arteries and veins in the brain—specifically, an arteriovenous malformation in the cerebrum. The most frequently observed problems related to a cerebral arteriovenous malformation (AVM) are headaches and seizures, cranial nerve afflictions including pinched nerve and palsy, backaches, neckaches, and nausea from coagulated blood that has made its way down to be dissolved in the cerebrospinal fluid.
Subarachnoid hemorrhage
Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain. Symptoms may include a severe headache of rapid onset, vomiting, decreased level of consciousness, fever, weakness, numbness, and sometimes seizures. Neck stiffness or neck pain are also relatively common. In about a quarter of people a small bleed with resolving symptoms occurs within a month of a larger bleed.