Synonyms
vernacular = “hydrocephalus “plural = hydrocephalus
Definition
A hydrocephalus is an increasing expansion of the cerebrospinal fluid (ventricle) of the brain as a result of a disturbed circulation, absorption or production of the cerebrospinal fluid.
Frequency distribution
50% of all patients affected by the clinical picture of “hydrocephalus/ hydrocephalus” are infants and small children, the other half are adults, whereby it is mainly people over 60 years of age who suffer from hydrocephalus. Based on this, 25% of hydrocephalus cases are congenital or combined with a defect of the neural tube (developmental stage of the central nervous system). The incidence of these inborn forms (congenital hydrocephalus) is 1 to 4 per 1000 births.
Symptoms in adults
The symptoms of hydrocephalus in adults are caused by the increase in pressure in the skull. In adults, the skull bone forms a closed space, which cannot be expanded. Due to the overproduction of cerebral fluid or a drain obstruction, the pressure on the brain tissue increases.
The cavities in the brain, which contain the cerebral fluid, expand and press on sensitive structures in the brain. This increase in pressure leads to failures similar to those that occur with strokes. Those affected complain of impaired vision, headaches and dizziness.
Movement disorders, such as insecure gait, are also known. In some cases, changes of character and memory disorders are also possible. In case of a late diagnosis, constrictions of the brain are also possible.
The affected persons faint because parts of the brain are constricted and their function is impaired. This includes in particular the brain stem, which contains the circulatory center and the respiratory center. This condition is acutely life-threatening.
In order to be able to make the diagnosis “hydrocephalus”, it is first and foremost necessary to take a medical history (anamnesis). This is followed by a neurological examination in which special attention is paid to the typical symptoms of hydrocephalus. Furthermore, imaging procedures are used, namely a computer tomogram (cCT) or a head MRI (cMRI, nuclear spin).
However, except in emergency situations, head MRI is usually the preferred method for detecting hydrocephalus. The recording of brain waves by means of an EEG (electroencephalogram) can also provide important information about the presence of hydrocephalus. Other diagnostic options include measuring the pressure of the cerebrospinal fluid or a scintigraphy.
The former is usually no longer used for diagnosis, the latter serves to detect disturbed absorption of cerebrospinal fluid with the help of radioactive substances. The circumference of the head should be measured regularly in order to detect an increase in volume of the skull and thus a hydrocephalus in time. To clarify an existing ventricle enlargement, the first step is an ultrasound examination (sonography) of the head and the next step is a CT or MRI of the head.
In addition, a reflection of the eye fundus is helpful to detect bleeding or congestion papilla as an indication of hydrocephalus. Magnetic resonance imaging (MRI) is also used to detect hydrocephalus. Here you will find all topics of diagnostics
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