Prognosis

Every disease has prognosis. Prognosis is a prediction of the future, the outcome of the disease, and the successful of the treatment. It is only a prediction of the doctor, because of that the prognosis can be true or otherwise.

The prognosis of the patient who undergoes the treatment is difficult to predict, although there is some correlation between the specific cause of hydrocephalus and the patient's outcome. It depends on how worse the hydrocephalus disease and time that hydrocephalus’s patients get the treatment from doctor.

 

The outcome of the hydrocephalus’s patient is better if they get the treatment earlier. But, if the patient gets the treatment late and the hydrocephalus disease is worse by that time, the patient may have brain damage and can cause death. Without treatment also, up to 6 in 10 people with hydrocephalus will die. 

CHILDREN

For the children, if they do not get the treatment, it can affect both physical and cognitive development. Even when undergo treatments, some children who have hydrocephalus disease may have lower intelligence, memory and visual problem.

 

However, many children diagnosed with hydrocephalus treatment, therapies, and educational intervention lives like a normal children with a few limitation. Treatment by an interdisciplinary team of medical professional, rehabilitation specialist, and educational expert is critical to positive outcome. Treatment of patients with hydrocephalus is life-saving and life-sustaining.

 

NORMAL PRESSURE HYDROCEPHALUS

For the normal pressure hydrocephalus, some may experience temporary improvement even though did not go for treatment. Usually people who did not undergo for the hydrocephalus’s treatment, their condition become worse from day to day.

 

Sources:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002538/
http://pediatrics.about.com/cs/conditions/a/hydrocephalus_3.htm
http://www.onlymyhealth.com/what-prognosis-hydrocephalus-12977615746
http://nervous-system.emedtv.com/hydrocephalus/hydrocephalus-prognosis.html

Diagnosis

Diagnosis of Hydrocephalus Disease

1) The common diagnosis test to determined hydrocephalus disease is by using cranial imaging techniques such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), or pressure-monitoring techniques. 

              Magnetic Resonance Imaging (MRI)

2) The diagnosis test of hydrocephalus is based on the answer given by an individual to the doctor about signs and symptoms.  

3) The other diagnosis test to determined hydrocephalus disease is neurological exam. In this procedure the neurologist may ask questions and conduct relatively simple tests in the office to judge: 

Reflexes

• Muscle strength
• Muscle tone
• Sense of touch
• Vision and eye movement
• Hearing
• Coordination
• Balance
• Mental status
• Mood

Sources:

http://www.ninds.nih.gov/disorders/hydrocephalus/detail_hydrocephalus.htm

http://www.mayoclinic.com/health/hydrocephalus/DS00393/DSECTION=tests-and-diagnosis

http://static.ddmcdn.com/gif/adhd-mri.jpg

http://static.ddmcdn.com/gif/mri-10.jpg

Treatments

  

Hydrocephalus can be treated with two way which are:

1) Shunt placement

2) Endoscopic Third Ventriculostomy

 

   

SHUNT PLACEMENT

A shunt drains excess cerebrospinal fluid from the brain to another part of the body, such as the abdomen, where it can be more easily absorbed.

• The surgical insertion of drainage system called shunt is a treatment for hydrocephalus disease.  A shunt is a flexible but sturdy plastic tube.

•  A shunt system consist of shunt, a catheler, and a valve. Catheler have two end,  one of the end of catheler are placed within a ventricle inside the brain or in the CSF outside the spinal cord. 

• The other one end of catheler place inside the body, usually it placed within the abdominal cavity. However, it also can be placed  as a chamber of the heart or areas around the lung where the CSF can drain and be absorbed. 

• Mean while,  a valve located along the catheler. Functions of valve is to maintain one-way flow and regulate the rate of CSF flow. 

• People who have hydrocephalus usually need a shunt system for the rest of their lives, and regular monitoring is required

 

 VIDEO ON SHUNT PLACEMENT

  

ENDOSCOPIC THIRD VENTRICULOSTOMY

  

• The alternative procedure of hydrocephalus's treatment called endoscopic third ventriculostomy. There are only limited number of hydrocephalus's patient that can be treated using this procedure. 

• During this treatment, the neurosurgeon used a small camera designed to visualize small and difficult to reach surgical areas. 

• After the target surgical area reaches, the neurosurgeon make a tiny hole in the floor of third ventricle. The tiny hole allowing the CSF to bypass the obstruction and flow toward the site of resorption around the surface of the brain.

  

 VIDEO ON ENDOSCOPIC THIRD VENTRICULOSTOMY

  

Complications of surgery

 

Both surgical procedures can result in complications. Shunt systems can stop draining cerebrospinal fluid or poorly regulate drainage because of mechanical malfunctions, blockage or infections. The passage created during a ventriculostomy can suddenly close.

Any failure requires prompt attention, surgical revisions or other interventions. Signs and symptoms of problems may include:

• Fever
• Irritability
• Drowsiness
• Nausea or vomiting
• Headache
• Vision problems
• Redness, pain or tenderness of the skin along the path of the shunt tube
• Abdominal pain when the shunt valve is in the abdomen
• Recurrence of any of the initial hydrocephalus symptoms

  

Sources :

http://www.youtube.com/watch?v=Qmym2iFVNw8

http://www.youtube.com/watch?v=uimMXTzC1B8

http://nervous-system.emedtv.com/hydrocephalus/hydrocephalus-treatment.html

http://www.mayoclinic.com/health/hydrocephalus/DS00393/DSECTION=treatments-and-drugs

http://www.cerebralpalsyandotherdisorders.com/visual/shunt-placement.jpg

Symptoms and Signs

Symptoms of hydrocephalus depend on:

1) Age

2) Amount of brain damage

3) What is causing the build up of Cerebrospinal Fluid (CFS)

Symptoms in infants

• Rapidly increase size of head
• Sunset eyes 
• Vomiting
• Sleepiness
• Irritability

Sunset eyes

 

Increase size of head

  

Symptoms in older children or adults:

• Brief, high-pitched cry 
• Problem in balanced their body
• Difficulty feeding
• Uncontrolled eyes movement
• Change in facial appearance
• Loss of bladder control
• Vomiting
• Slow growth
• Irritability or poor temper control
• Slow and have difficulty to walk or move
• Loss of memory
• Blurred or doubled vision

 

 

 

Sources :
http://www.medicinenet.com/hydrocephalus/page2.htm#4whatis
http://health.nytimes.com/health/guides/disease/hydrocephalus/overview.html

Causes, Incidence and Risk Factors

Hydrocephalus is due to a problem with the flow of the fluid that surrounds the brain. This fluid is called the cerebrospinal fluid, or CSF. It surrounds the brain and spinal cord, and helps cushion the brain.

CSF normally moves through the brain and the spinal cord, and is soaked into the bloodstream. 

CSF levels in the brain can rise if:

• The flow of CSF is blocked
• It does not get absorb into the blood properly
• your brain makes too much of CSF

 

Too much CSF puts pressure on the brain. This pushes the brain up against the skull and damage brain tissue.

Hydrocephalus may begin while the baby is growing in the womb. It is common in babies who have a myelomeningocele, a birth defect in which the spinal column does not close properly.

Hydrocephalus may also be due to: 

• Genetic defects
• Certain infections during pregnancy

 

In young children, Hydrocephalus may result from the following conditions: 

• Infections that affect the central nervous system such as Meningitis or Encephalities especially in infants
• Bleeding in the brain during or soon after delivery especially in premature babies
• Injury before, during or after childbirth, including Subarachnoid hemorrhage
• Tumors of the central nervous system, including the brain or spinal cord
• Injury or trauma  
  
  

Hydrocephalus most often occurs in children, but may also occur in adults and the elderly.

Sources : 
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002538/

Types

Three main types of hydrocephalus

1) Congenital Hydrocephalus - hydrocephalus that present at birth

2) Acquired hydrocephalus - hydrocephalus that occur after birth

3) Normal Pressure Hydrocephalus - hydrocephalus that develop in older people

Sources:

1) http://www.cid.org.ro/sites/default/files/imagecache/ga_550/gallery_assist/3/gallery_assist154/poze%20hospice%20ianuarie%20002.jpg

Relationship between Hydrocephalus and the Brain

Cerebrospinal fluid or CSF is the fluid that surround the spinal cord and brain.

Cerebrolspinal fluid (CSF) has three important functions:

1) Protect the brain from damage

2) Act as the vehicle to remove waste product from the brain

3) Provide nutrient that the brain needed in order to function properly

The relationship between the brain and Hydrocephalus:

Hydrocephalus is cause by disturbance of CSF circulation in the brain. Too much CSF in the brain may cause ventricles which is abnormal widening of space in brain. It can pressure the tissue in the brain, pushed the brain up against the skull and damage brain's tissue. CSF is made continuously, and because of that balance between the production and absorption of cerebrospinal fluid are important. Hydrocephalus is the medical condition in which it blocks the normal flow of the CSF in the brain.

Source: Google image

Video on Hydrocephalus

Source: http://www.youtube.com/watch?v=6EWtiAoc3Sw

What is Hydrocephalus?

Hydrocephalus derived from the greek word. Hydro means water, whereas cephalus means brain. It also know as water in the brain. Hydrocephalus is a medical condition in which there is over-accumulation of fluid in the brain. The fluid called cerebrospinal fluid or CSF. Cerebrospinal fluid is what surrounds the brain and spinal cord and cushions them.

 

Sources:
1) http://www.lucinafoundation.org/birthdefects-hydrocephalus.html
2) http://byebyedoctor.com/wp-content/uploads/2011/08/hydrocephalus