Summary about Disease
Non-communicating hydrocephalus, also known as obstructive hydrocephalus, occurs when the flow of cerebrospinal fluid (CSF) within the brain's ventricular system is blocked. This blockage causes CSF to accumulate, leading to increased pressure within the skull. This increased pressure can damage brain tissue.
Symptoms
Symptoms vary depending on age and the severity of the hydrocephalus. Infants may present with:
Rapid increase in head circumference
Bulging fontanel (soft spot)
Prominent scalp veins
"Sunset sign" (eyes looking downward)
Irritability or lethargy
Poor feeding
Vomiting
Seizures Older children and adults may experience:
Headache
Nausea and vomiting
Blurred or double vision
Difficulty walking
Problems with balance
Urinary incontinence
Lethargy
Cognitive impairment (memory loss, confusion)
Personality changes
Causes
Non-communicating hydrocephalus is caused by a blockage within the ventricular system of the brain. Common causes include:
Congenital malformations: Such as aqueductal stenosis (narrowing of the aqueduct of Sylvius, which connects the third and fourth ventricles).
Tumors: Brain tumors can obstruct CSF flow.
Cysts: Arachnoid cysts or other cysts can block CSF pathways.
Infections: Infections like meningitis can cause inflammation and scarring that leads to blockages.
Hemorrhage: Bleeding in the brain can lead to blood clots that obstruct CSF flow.
Chiari malformation: A structural defect where brain tissue extends into the spinal canal.
Medicine Used
Medications are typically not the primary treatment for non-communicating hydrocephalus. While some medications like acetazolamide or furosemide can temporarily reduce CSF production, they are generally not a long-term solution. The primary treatment is surgical.
Is Communicable
No, non-communicating hydrocephalus is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
There are no specific precautions to prevent non-communicating hydrocephalus, as many of its causes are congenital or due to unforeseen events like tumors or hemorrhage. However, prompt medical attention for infections of the central nervous system (like meningitis) may reduce the risk of hydrocephalus as a complication. Genetic counselling may be relevant in certain instances of congenital malformation.
How long does an outbreak last?
Non-communicating hydrocephalus is not an "outbreak"-related condition. It is a chronic condition that develops due to a blockage of CSF flow. If left untreated, the symptoms will persist indefinitely. The duration of symptoms depends on the underlying cause and the time it takes to diagnose and treat the condition.
How is it diagnosed?
Diagnosis typically involves:
Neurological examination: Assessing reflexes, muscle strength, vision, and coordination.
Imaging studies:
CT scan: Provides detailed images of the brain to identify blockages, tumors, or other abnormalities.
MRI scan: Offers more detailed images of the brain tissue and CSF pathways.
Lumbar puncture (spinal tap): Rarely used for diagnosis but may be helpful in specific situations.
Intracranial pressure monitoring: Measures the pressure inside the skull, particularly useful for diagnosis and management.
Timeline of Symptoms
The timeline of symptoms varies greatly depending on the cause, the age of the individual, and the rate at which the blockage develops.
Congenital cases: Symptoms may be present at birth or develop soon after.
Tumor-related cases: Symptoms may develop gradually over weeks or months.
Post-hemorrhage cases: Symptoms can appear suddenly within days of the bleeding. The symptoms can worsen over time if the condition is left untreated.
Important Considerations
Early diagnosis and treatment are crucial to minimize brain damage and improve outcomes.
Treatment typically involves surgical intervention to bypass the blockage and restore CSF flow.
The most common surgical procedure is the placement of a shunt, which diverts CSF to another part of the body, such as the abdomen.
Endoscopic third ventriculostomy (ETV) is an alternative surgical procedure for some patients, which creates a new pathway for CSF flow within the brain.
Regular follow-up appointments are necessary to monitor shunt function and assess for any complications.
Long-term prognosis depends on the underlying cause, the severity of the hydrocephalus, and the effectiveness of treatment. Some individuals may require lifelong management.