Hydrocephaly is a condition that results from the accumulation of cerebrospinal fluid (CSF), the normal fluid in the brain. Cerebrospinal fluid is a fluid found in the brain chambers (ventricles), around the brain, and in the spinal canal, and it protects, nourishes, and balances brain tissue. However, in the case of hydrocephalus, the normal circulation of this fluid is blocked and it accumulates in the brain chambers, which enlarge (ventricular dilation). Since the fluid cannot be discharged out of the skull, the blood pressure increases inside the brain and the symptoms of hydrocephalus occur because the brain functions are impaired. and fourth ventricles) is an interconnected cerebrospinal fluid drainage system. Most of the cerebrospinal fluid (CSF) is produced by the velvety organ called the choroid plexus in the lateral ventricles of the brain, and some of it is produced by the brain itself and transferred to the third ventricle located in the middle of the brain. From here, it is evacuated to the 4th ventricle in the cerebellum, and from there to both the brain surface and the spinal cord, through the channel we call aquaductus (aquaductus Sylvii). Then, CSF is absorbed by suction cups on the brain surface and drawn into the veins. This circulation process is synchronized with the heartbeat and continues for 24 hours. The daily amount of CSF produced in the adult human brain is 400-500 cc. When this evacuation system is disrupted, while the ventricles expand due to CSF accumulation, the pressure in the brain tissue increases and intracranial pressure increase syndrome (CIBAS) occurs. This condition is called hydrocephalus. For example, this flow may be blocked due to a bleeding, tumor, infection or a congenital structural defect and hydrocephalus may develop. Hydrocephalus causes increased pressure in the brain and damage to brain tissue. Many factors may play a role in the formation of hydrocephalus. These include congenital structural abnormalities, infections (such as meningitis), cerebral hemorrhage, tumors, brain trauma, and certain neurological diseases. Hydrocephalus can occur at any age, but usually begins in infancy and childhood. The most common cause of hydrocephalus in children and the elderly is cerebral hemorrhages.
Types of Hydrocephalus
Hydrocephalus can be divided into different types. Two There are main types: communicating (non-obstructive) hydrocephalus and occluded (obstructive) hydrocephalus. In the case of communicating hydrocephalus, the cerebrospinal fluid continues to circulate normally, but its absorption is reduced or impaired. This type of hydrocephalus develops after meningitis. In the case of occluded hydrocephalus, the flow of cerebrospinal fluid between the ventricles is blocked due to an obstruction. Tumors generally cause this type of hydrocephalus. Symptoms Symptoms of hydrocephalus may vary depending on age and the rate of development. In infants, symptoms may include rapid increase in head circumference, stretched fontanel (swelling of fontanel), restlessness, vomiting, eye movement abnormalities, headache, fatigue, and regression in motor skills. In children and adults, symptoms can include headache, nausea, vomiting, imbalance, vision problems, memory problems, lack of coordination, and behavioral changes. Hydrocephalus that develops after hemorrhages in adults is urgent and can be fatal if not treated quickly. But hydrocephalus is a disease that usually progresses slowly and attracts attention with headache. As hydrocephalus progresses, vision problems may be added and usually begin 3 weeks after hydrocephalus begins. Sometimes it starts with blurred vision in both eyes and sometimes on one side. This is due to optic nerve (eye nerve) edema. In this process, hydrocephalus is not treated urgently. Optic nerve edema should be evaluated in detail by performing a fundus examination. In untreated patients, optic nerve edema transforms into optic nerve atrophy and results in permanent vision loss. Hydrocephalus in the elderly usually progresses slowly and may not show symptoms for years. Over time, it causes complaints such as headache, imbalance, memory loss and urinary incontinence.
Treatment
Treatment of hydrocephalus usually includes surgical intervention. With surgery, a drainage system is placed to ensure the normal flow of cerebrospinal fluid. This system drains the cerebrospinal fluid from the area of excess accumulation to another area, usually into the abdomen. These evacuation systems usually contain a thin tube called a shunt and a valve (valve) that acts as a siphon. Shant systems allow a steady flow of cerebrospinal fluid, thus resulting in hydrocephalus. alleviates the pain. The most commonly used shunt systems are the one that evacuates the cerebrospinal fluid called ventriculoperitoneal shunt from the brain to the abdominal cavity (ventriculoperitoneal shunt). Some cases of hydrocephalus may not require surgery and treatment can be managed with medications or other methods. Treatment options may vary depending on the cause of hydrocephalus, age, severity of symptoms, and other factors. In addition, there are many shunt brands and mechanisms with different characteristics. Therefore, it is important to consult with a specialist to determine the most appropriate treatment plan for an individual diagnosed with hydrocephalus
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