Hydrocephalus: Diagnosis, Treatment, and Prenatal Interventions
Apr 16, 2024
The diagnosis of hydrocephalus, often described as "water on the brain," can be a source of concern and numerous questions for parents. This condition involves an excessive buildup of cerebrospinal fluid (CSF) within the ventricles of the brain, potentially leading to increased pressure and affecting brain function.
What Is Hydrocephalus?
Hydrocephalus results from excessive or abnormal accumulation of CSF, causing increased intracranial pressure. Without timely diagnosis and management, hydrocephalus may weaken brain function and result in neurological damage. Early detection and intervention are vital to address this condition effectively.
Early Signs and Symptoms
Prompt recognition of hydrocephalus is crucial for successful treatment. Symptoms include:
Abnormally large head size (head circumference > 97th percentile)
Rapid head growth, with head circumference crossing normative percentiles.
Bulging fontanel (soft spot on the head)
Vomiting
Sleepiness or irritability
Poor feeding habits
Persistent downward gaze in the eyes
Diagnosis and Treatment
The pathway to diagnosing hydrocephalus typically includes thorough physical examinations alongside advanced imaging techniques, including ultrasounds, MRIs, or CT scans. In cases of myelomeningocele, a serious form of spina bifida, hydrocephalus can be identified even before birth. This early detection is crucial, as it opens the door to prenatal interventions that can substantially reduce the likelihood of hydrocephalus developing after the baby is born.
When it comes to treatment, the approach is highly personalized, often involving surgical procedures to manage hydrocephalus effectively. The most common strategies include the implantation of shunt systems, which redirect excess CSF away from the brain to another part of the body where it can be absorbed, or performing an endoscopic third ventriculostomy (ETV), which creates a bypass for fluid to exit out of the brain's ventricles, and into normal physiologic pathways of CSF absorption. For babies diagnosed with myelomeningocele, the possibility of prenatal surgical repair represents a significant advancement, offering a proactive measure to mitigate the risk of hydrocephalus and its associated complications.
The Importance of Prenatal Care and Counseling
A prenatal diagnosis of hydrocephalus can be emotionally challenging. Specialized counseling offers essential support, providing insights into the condition, discussing potential outcomes, and preparing parents for the treatments ahead. These sessions are crucial for empowering parents to make informed decisions about their child’s care.
A Journey of Hope
Advancements in medical technology and surgical treatment have enabled many individuals with hydrocephalus to lead fulfilling lives. Ongoing collaboration with healthcare professionals for regular monitoring and management is essential. Early diagnosis and appropriate treatment set the foundation for a brighter future.
Community and Support
You are not alone in this journey. A vibrant community exists, comprising families familiar with the challenges of hydrocephalus. The Hydrocephalus Association, along with other organizations, provides a wealth of resources, support networks, and shared experiences to ensure families do not face this path in isolation.
The journey with hydrocephalus, from prenatal diagnosis to lifelong care, presents its challenges but offers opportunities for hope and the enduring strength of parental love. Equipped with knowledge and supported by a compassionate community, parents are empowered to advocate for their child’s health and look toward the future with optimism.
Nationwide Children’s Hospital is committed to offering comprehensive care and support for individuals with hydrocephalus, featuring a team of six dedicated neurosurgeons and a renowned fetal medicine center specializing in prenatal diagnosis, counseling, and specialized surgeries. As a participating site in the Hydrocephalus Clinical Research Network and a leader in genomic research through the Abigail Wexner Institute for Genomic Medicine, we are at the forefront of efforts to advance standardized care and personalized treatment based on genetic profiles
Connect with the Neurosurgery Team at Nationwide Children’s Hospital and learn about prenatal diagnosis and care by visiting our Fetal Center.
Albert Isaacs, MD, PhD, is a pediatric neurosurgeon at Nationwide Children’s Hospital and an assistant professor of Neurological Surgery at The Ohio State University College of Medicine. Dr. Isaacs obtained his Bachelor of Science degree from Carleton University in Ottawa, followed by his medical degree from the University of British Columbia in Vancouver. During residency training in Neurosurgery at the University of Calgary, Dr. Isaacs completed graduate studies in Neuroscience at both the University of Calgary and Washington University School of Medicine in St. Louis. He completed his Pediatric Neurosurgery fellowship at Vanderbilt University’s Monroe Carell Jr. Children’s Hospital in Nashville. Dr. Isaacs’ extensive background and training across various institutions and countries reflect his unyielding commitment to excellence and dedication to mentoring the next generation of neurosurgeons.
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