Classification of the hydrocephalus in babies according to localization
Furthermore, there is a classification of the clinical picture “hydrocephalus” according to localization. One distinguishes here between three forms:
- Hydrocepahlus internus = dilatation of the ventricles or internal cerebrospinal fluid
- Hydrocepahlus externus = expansion of the external cerebrospinal fluid spaces
- Hydrocephalus communicans = expansion of the inner and outer CSF spaces, existing connection of both spaces
Acquired or congenital hydrocephalus?
Furthermore, the hydrocephalus can be classified according to the time of origin, because a hydrocephalus in babies can be either congenital or acquired. The congenital, early childhood forms are caused by narrowing or obstruction of the natural connection or drainage channels, by space requirements in the brain, by malformations in the area of the spinal column, spinal cord or brain, or by prenatal infections with, for example, toxoplasma (toxoplasmosis) or cytomegalovirus (CMV). An example of such a narrowing is aqueductal stenosis, in which the connecting pathway between III.
and IV. ventricle, the aqueduct (aqueductus cerebri), is not completely continuous, so that the cerebrospinal fluid cannot circulate freely. Atresia of the ventricular outflow pathways exist with regard to the routing of connections of the inner cerebrospinal fluid spaces.
This is understood to mean the lack of opening of these pathways, whereby preferably the IV. ventricle is affected. As a consequence, a cerebrospinal fluid outflow disorder also occurs.
Malformations that cause hydrocephalus in babies are the Arnold Chiari Malformation, the Dandy Walker Malformation or the Cranium bifidum. In contrast to the hydrocephalus in babies, acquired hydrocephalus can occur due to ventricular bleeding and inflammation or adhesions of the brain and meninges. Furthermore, cancer can cause hydrocephalus, such as plexus papilloma, which is a benign new formation of the CSF-producing plexus choroideus. As a result of this papilloma, the amount of cerebrospinal fluid produced increases.
Diagnosis of hydrocephalus in the baby
In order to diagnose a hydrocephalus in a baby as such, imaging techniques are best suited to depict the brain and its surroundings. Often an ultrasound is performed, as this is the least stressful for the baby. Alternatively, a computer tomography or a nuclear spin can be arranged.
However, the risk of radiation exposure for the baby must be weighed up. CT and MRI are used as diagnostic tools, especially for somewhat older children. An ultrasound scan can be performed simply through the fontanel on the baby’s head.
This is a site where the bones of the skull do not completely grow together until several months later. The doctor gets a good view of the brain and the cavities filled with neural fluid. Here an enlargement of these cavities can be observed in a hydrocephalus.
Depending on the origin, the cause of the excessive accumulation of cerebral fluid can also be assessed. A hydrocephalus in babies can usually be diagnosed early. Nowadays, an ultrasound scan is already performed during pregnancy as part of a preventive examination, in which, among other things, hydrocephalus is to be excluded.
If the hydrocephalus is already detected then it can be treated quickly. However, it can also happen that the hydrocephalus does not become visible in the baby until after birth. If a suspicion exists, a doctor should be consulted as soon as possible.
