Introduction

Hydrocephalus is a condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within the brain’s ventricles, leading to increased pressure inside the skull. When this condition develops after birth due to factors such as injury, infection, or a brain tumor, it is referred to as acquired hydrocephalus. This blog aims to provide a comprehensive understanding of acquired hydrocephalus in children, its causes, symptoms, and the treatment options available.

What is Acquired Hydrocephalus?

Acquired hydrocephalus occurs when there is an imbalance between the production and absorption of CSF after birth, leading to its accumulation in the brain. Unlike congenital hydrocephalus, which is present at birth, acquired hydrocephalus can develop at any age due to various factors. The condition can be life-threatening if not treated promptly, as the excess fluid increases intracranial pressure and can cause damage to brain tissues.

Causes of Acquired Hydrocephalus in children

The causes of acquired hydrocephalus in children are diverse and can include:

  1. Infections: Meningitis, an infection of the membranes surrounding the brain and spinal cord, can lead to inflammation and block the pathways through which CSF flows, causing hydrocephalus.
  2. Head Injuries: Traumatic brain injuries, especially those involving skull fractures or bleeding within the brain, can disrupt the normal flow or absorption of CSF, leading to hydrocephalus.
  3. Brain Tumors: Tumors within the brain can obstruct the flow of CSF, leading to its accumulation.
  4. Hemorrhage: Bleeding within the brain, particularly in premature infants, can result in hydrocephalus due to the clotting and scarring that blocks CSF pathways.
  5. Cysts and Other Abnormalities: Cysts or other structural abnormalities within the brain can also obstruct the flow of CSF, leading to hydrocephalus.

Symptoms of Acquired Hydrocephalus in Children

The symptoms of acquired hydrocephalus can vary depending on the child’s age and the severity of the condition. Common symptoms include:

  • Infants: An unusually large head size, rapid increase in head circumference, bulging fontanel (soft spot on the head), vomiting, irritability, seizures, and poor feeding.
  • Older Children: Headaches, nausea, vomiting, blurred or double vision, balance problems, delayed development, changes in personality, and difficulties with concentration or school performance.

Diagnosis

Diagnosing acquired hydrocephalus typically involves a combination of clinical evaluation and imaging studies. A pediatrician or neurologist may conduct a physical examination to check for signs of increased intracranial pressure. Imaging techniques such as ultrasound (in infants), MRI, or CT scans are used to visualize the brain’s structure and identify the presence of excess CSF.

Treatment Options

The primary treatment for acquired hydrocephalus is surgical intervention, which aims to reduce the excess CSF and relieve pressure on the brain. The most common surgical procedures include:

  1. Ventriculoperitoneal (VP) Shunt: A VP shunt is a device that is surgically placed in the brain’s ventricles to divert excess CSF to another part of the body, usually the abdominal cavity, where it can be absorbed. The shunt system typically includes a catheter, a valve to regulate the flow of CSF, and tubing.
  2. Endoscopic Third Ventriculostomy (ETV): ETV is a procedure where a small hole is made in the floor of the third ventricle, allowing CSF to bypass the obstruction and flow toward the site of absorption. This procedure is often considered when a shunt is not feasible or has failed.
  3. Treatment of Underlying Causes: In cases where hydrocephalus is caused by a tumor, infection, or bleeding, addressing the underlying condition is crucial. For instance, antibiotics may be administered for infections, and surgery or radiation may be necessary for tumors.

Living with Hydrocephalus

Children with treated hydrocephalus often lead full, active lives, but they may require ongoing medical care and monitoring. Shunts, for example, can sometimes malfunction or become infected, necessitating additional surgery. Regular follow-ups with a healthcare provider are essential to monitor the child’s development, check for complications, and adjust treatments as needed.

Bottom Line

Acquired hydrocephalus is a serious condition that can have significant impacts on a child’s health and development. Early diagnosis and prompt treatment are crucial for preventing long-term complications and ensuring the best possible outcomes. With advances in medical care, many children with hydrocephalus can manage the condition effectively and go on to live healthy, fulfilling lives.

Parents and caregivers should be vigilant in recognizing the symptoms of hydrocephalus and seek medical attention if any signs are observed, ensuring that their child receives the care they need.