More About Hydrocephalus
in layman's terms
Hydrocephalus is defined as: a build-up of fluid inside the brain
It literally means: water on the brain
What kinds of fluid? Cerebral Spinal Fluid (CSF) or blood from a brain bleed of some
type.
 |
| photo from nursingcrib.com |
hydrocephalus does when it goes untreated for a period of time. The fluid that is naturally produced
by the brain builds up in the ventricles because it cannot drain into the bloodstream due to a
blocked ventricle, or multiple ventricle blockages. The brain is pushed to the sides of the skull and
the pressure on the brain can very likely cause brain damage. Hydrocephalus is much more
common than you probably previously thought. Roughly 1 in every 500 children is diagnosed, and
thousands of adults and elderly every year. (It's difficult for researchers to know the actual number,
but to give you an idea, my son's neurosurgeon said that about half of his patients have
Hydrocephalus and I'm sure he sees many people, working at a major hospital.)
photo from runkle-science.wikispaces.com/HYDROCEPHALUS
Here is another good picture labeling the different ventricles. With Congenital Hydrocephalus, any of
these can be blocked for various reasons. Some of the reasons include: a cyst, a stroke, a
tumor, trauma to the head damaging the ventricle, infection in the
pregnant mother, genetic disorder, or anatomical anomaly. The type
that my son has is called Aqueductal Stenosis meaning the Aqueduct of Sylvius is
blocked, which is the narrow passage between the 3rd and 4th ventricles. His case is due to an
anatomical anomaly that is not genetic and has no cause found. Because babies with Congenital
Hydrocephalus cannot have a shunt placed until after birth, their heads are typically very large for
their bodies. My son was born with a head roughly the same circumference as the average adult.
I would like to note that anyone can also get Hydrocephalus at any age. Many elderly develop
Hydrocephalus and it is misdiagnosed as Alzheimers.
Hydrocephalus is not a disease, it is a condition, and therefore cannot be cured.
So What Can Be Done?
 |
| photo from webspace.webring.com |
A VP shunt, and a VA shunt. The difference is
where the end of the catheter ends up: the heart
or the stomach. Usually a VP shunt is placed
unless there is a reason why the VP shunt would
not work based on the child's anatomy and the doctor's recommendations. The shunt is located
underneath the skin. It is fed through a hole drilled into the skull into the brain to the proper position
for drainage to occur. An incision is made in the stomach and the second part of the catheter is
threaded through to where the two catheters can meet and the valve can be placed to connect them.
The fluid is not drained all out at once: this would cause ventricular collapse. It is drained over time
until it is at a point where it is lessened. My son has seen miraculous recovery after his shunt was
placed and the fluid drained, as you can read about in Jake's First Year. He does still have
more CSF than the regular person and his ventricles may always be slightly larger and fluid-filled as
well. The point is to bring it down to a manageable range.
Third-Ventriculostomy is a less common treatment where there is a possibility of the
patient living without a shunt. A small hole is made in the brain tissue where the fluid can drain out
naturally. The problem is that the hole made can heal up and close. If the patient is above 2 years old
the chances are much better that the hole will stay open. Infants are usually never given this
procedure because the failure rate is significant.
Here is a picture of my son's shunt roughly a week after
placement. You can see it quite well underneath the skin at this
point.
The Problem with Shunts: There are just so many! Failure, infection, over-
drainage, under-drainage.
Anyone who has a shunt has a 100% guarantee that it will eventually fail and then (in most every
case) have to be replaced. Why do shunts fail you ask? They get clogged from brain tissue
growth, they have to be replaced because they are under or over-draining. Basically they
fail because they are a man-made object that has not changed a whole lot in the years since they were
invented in 1956. A shunt is basically a life-long and life-saving companion, but a lot of funding is
needed to help further the research on improving shunts and improving the lives of the many many
people living with Hydrocephalus. We also need to raise awareness.
Signs of Shunt Failure:
irritability, vomiting, loss of appetite,
change in personality, incontinance, headache, eyes forced
downward (sunset), loss of balance, and many more.
Our Neurosurgeon goes over the signs each time we go in for a visit, because, as I've said before,
they will present at some point in time. If the person with Hydrocephalus, or their caretaker, ever
suspect a shunt problem, the procedure is generally to call your surgeon and do what they tell you. If
you can't make it before hours you will usually be sent to the emergency room. They will need a
CT scan to be compared to their last MRI or CT scan. Patients with Hydrocephalus have to get
one or the other at least once per year.
A shunt has a 50% chance of failure within the first year of getting one
and a 20% chance of infection in the first 6 months.
MORE INFO
If you would like to know more about Hydrocephalus, I would recommend visiting this site for more
information rather than trying to google it. Actually, I would recommend this site very highly if you
want to know more detail than I provided, see some pictures of children with Hydrocephalus, see
some more of the equipment used, and also information on cord blood infusion. This site
also led me to other blogs and was my saving grace when I found out about my baby's condition and
was looking for some accurate information on daily life.
The reason, primarily is that I just googled it and I forgot all the horrible things come up, especially
under 'images'. Just trust me, don't do it. Many of those pictures are also from the 50's and 60's before
treatment was as good as it is now.
End Note: Please do not reference this page as medical information or consult my page instead of
your doctor. I am a mom, not a doctor or professional.
No comments:
Post a Comment