Hydro means “water”. Sefali also means "head". Hydrocephalus, which is a combination of these two words, means accumulation of water inside the skull. Inside the skull are the brain, vessels and nerves. The brain, nerves and vessels float in spinal fluid. Hydrocephalus also occurs if the amount of this fluid increases. The increase in the amount of water causes the pressure in the brain to increase and therefore causes damage to the brain.
REASONS FOR INCREASE WATER
There are 3 main reasons for the increase in the amount of fluid in the brain:
EXCESSIVE. WATER PRODUCTION
There are structures in the brain that secrete water. If there is a tumor in those structures, more water is secreted. This causes water accumulation.
REDUCTION IN WATER ABSORPTION
650 cc of water is produced in our brain every day. This water mixes with the blood from the spinal cord. In some infections such as meningitis, after brain hemorrhage, and in the presence of some tumors, blockage occurs in the drains that allow water to mix with the blood. As a result of the blockage, water accumulates.
BLOCKAGE IN THE BRAIN CHAMBER
The water in the brain passes through various chambers in the brain and mixes with the blood. When there is a blockage in one of the chambers, water accumulates. A tumor in the chambers, a previous infection, or bleeding may cause this blockage.
WHO IS IT SEEN?
Hydrocephaly is a disease that can be seen at any age. However, it is very rare in young people. It is mostly seen in children and elderly people over 60 years of age. In most cases of hydrocephalus seen in childhood, the diagnosis is made before birth, at birth or in the neonatal period. The cause of hydrocephalus seen in the elderly is not fully known. However, reasons such as shrinkage of the brain and increased blockage in capillaries with age are emphasized.
Hydrocephalus seen in childhood and adulthood differs in terms of symptoms.
HYDROCEPHALIA IN INFANTS AND CHILDREN
It is most commonly seen in babies aged 0-2 months. Brain tumors, infections such as meningitis, and brain hemorrhages in the womb are among the causes. Structural blockage of the water channel in the baby's brain is also a common cause. Baby's hydrocephalus in the womb even understandable. If the condition is considered severe, surgery is possible in the womb. However, follow-up is usually done after the baby is born. After a definitive diagnosis is made, surgery is planned. In some cases, it is not clear whether the baby has Hydrocephalus or not as soon as it is born. However, over the following months, it is observed that his head is larger than other children due to water accumulation. Enlargement of the head is the most important symptom of childhood Hydrocephalus. The cause of Hydrocephalus is examined with MRI and brain ultrasonography examinations. If the baby has a tumor, it will be removed surgically. If hydrocephalus occurs due to other reasons, shunt surgery is performed.
HYDROCEPHALY IN ADULT AGE
In this Hydrocephalus, defined as normal pressure hydrocephalus, the brain chambers enlarge after the absorption of cerebrospinal fluid decreases. It manifests itself with significant symptoms, especially in people over the age of 60.
- Gait disturbance
- Imbalance
- Speech impairment
- Forgetfulness
- Urinary incontinence is the most common symptom.
As long as the complaints do not affect daily life, they are followed by the specialist. However, if the complaints increase, shunt surgery is recommended.
TREATMENT SHUNT SURGERY
It is not possible to treat hydrocephalus with medication. Therefore, if hydrocephalus occurs due to reasons other than tumor, shunt surgery is performed. In this surgery performed under general anesthesia, a small hole is made in the skull and the tip of the catheter is placed in the area of the brain where the cerebrospinal fluid is located. Then, a tunnel is opened under the skin and the other end of the catheter is transferred to the abdominal cavity where the fluid can be absorbed. Difficulties are experienced after shunt surgery in children. Problems such as catheter infection, shortening, or rupture may occur. As the child grows, surgery must be performed again. For this reason, there are children who have to undergo surgery 10-15 times. However, after reaching adulthood, everything becomes stable. Unless there is an obstruction or infection in the shunt, a new surgery is not required. Patients who undergo surgery usually need a shunt for life. Therefore, its removal is not recommended. The shunt helps the person continue his normal life.
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