Hydrocephalus, in Latin, hydrocephalus, means collection of water in the brain. The more correct meaning is the increase in the accumulation of cerebral spinal fluid inside the cerebral ventricular cavities, which leads to an increase in the pressure of the brain chamber and causes damage to the brain tissue naturally.
The brain has four cerebral ventricular cavities, and between them are narrow passages. Cerebral spinal fluid is secreted from within the ventricular cavities at a rate of half a liter per day. This transparent fluid passes from inside the ventricular cavities through narrow passages to the periphery of the brain and spinal cord to form a cushion and shock shield around them, after which this liquid is absorbed. With the same speed of its secretion into the blood circulation, which gives balance and stability to the volume of fluid and its pressure inside the brain, and among the functions of the fluid is also the distribution of nutrients for the brain, and when a blockage occurs in those passages between those four ventricles, the cerebral spinal fluid collects inside the cavities, which leads to their expansion and increased pressure on the brain tissue And hurt her. This type of ascites is called obstructive hydrocephalus.
The obstruction is usually in the duct connecting the third and fourth ventricular cavities. This type of ascites occurs in newborns as a result of a congenital disorder in the aforementioned passages or blockage of the canal when a tumor or bleeding occurs or an injury to its area leads to blockage of these passages. It occurs at all other ages.
And when a disturbance occurs in the rate of absorption of the cerebral spinal fluid into the blood vessels as a result of meningitis, encephalitis, or hemorrhage, so that the rate of absorption of the cerebral spinal fluid into the blood vessels is much less than the rate of fluid secretion, then the cerebral spinal fluid collects in all the four ventricular cavities, which leads to their widening and height cerebral pressure inside. This type is called communicative dropsy.
Symptoms in fetuses may be seen through ultrasound imaging of the fetus in its mother’s womb, with an increase in the size of the head and expansion of the cerebral ventricular cavities. Congenital hydrocephalus may be accompanied by other congenital defects such as neurocele with the spinal cord.
At birth, the size of the head is large in relation to the face, and the size of the head increases by a large percentage that is not commensurate with the normal growth of the newborn. In adults, the symptoms are the result of increased cerebral pressure, including: headache, vomiting, visual disturbances, balance disorder, memory and concentration disorder, and may lead to death in If not treated. The incidence of congenital hydrocephalus reaches one in every five hundred births, and most of them are diagnosed before birth, during or after birth.
Diagnosis of hydrocephalus
Fetal hydrocephalus can be diagnosed in mid-fetal age through uterine imaging. After birth, an accurate diagnosis can be made after taking a history, a clinical examination, a CT scan of the brain or an MRI of the brain.
The conventional treatment of hydrocephalus is surgical by implantation of shunt of cerebral spinal fluid from the brain to the abdomen (Ventriculoperitoneal Shunt: V-P Shunt).
We perform this operation using general anesthesia. Through a small hole in the skull, we insert a tube with a diameter of 2 mm into the cavity of the expanding cerebral lateral ventricles and connect it to a special valve that is implanted under the scalp and is also connected to a thin tube under the skin of the neck and chest and heading to the abdomen, where it ends there around the intestines and stomach. In this way, the implanted device only drains excess fluid from the head into the abdomen for absorption there. Of course, the device is under the skin and under the scalp, and is invisible, and the patient does not feel it, and it is forever