Hydrocephalus

On the day Jacob was born I had started to “leak” fluids. I went in to the doctor and no one wasreally worried I wasn’t due for another 3 1/2 – 4 weeks. As the tech was doing an ultrasound she saw something that wasn’t right, more fluid in the baby’s head than there should have been. But this tech was brand new and so they sent us to the hospital for a more in depthultrasound by a doctor with some years under his belt. This”professional” found nothing unusual and said not to worry. They were planning on sending me home as I wasn’t loosing any fluid they could see and I wasn’t feeling contractions. After I final check much to my alarm they said wow your dilating fast don’t you feel that? LOL painless contractions what a way to have them! 20 minutes later Jacob who had been sitting breech was delivered by emergency C Section. Baby was fine he was early, a little small and a little jaundiced but they gave him a clean bill of health and we went home when he was 4 days old. Then at his two week check up the ped noticed the same thing I had, Jacobs head seemed larger than normal. I mentioned that the first tech thought she had seen more water in his head than there should have been and he sent us for an ultrasound of Jacobs head, they sent us to the neurosurgeon who told us all about Hydrocephalus and shunts. That first tech was an angel in disguise if not for her we would have waited a little longer and maybe there would have been more damage. He was diagnosed when he was 2 weeks old and he had a VP shunt placed when he was 4 weeks old. They gave him time to gain some weight while keeping a close eye on the elevating pressure.

Hydrocephalus comes from Greek words: hydro means water, cephalus means head. Some know it as “water head” or “water on the brain” Hydrocephalus is an abnormal accumulation of fluid—cerebrospinal fluid, or CSF—within cavities called ventricles inside the brain. This condition may occur at any age. CSF is produced in the ventricles, circulates through the ventricular system in the brain and is absorbed into the bloodstream. CSF is in constant circulation and has many functions. It surrounds the brain and spinal cord and acts as a protective cushion against injury. CSF contains nutrients and proteins that are needed for the nourishment and normal function of the brain. It carries waste products away from surrounding tissues. Hydrocephalus occurs when there is an imbalance between the amount of CSF that is produced and the rate at which it is absorbed. As the CSF builds up, it causes the ventricles to enlarge and the pressure inside the head to increase.

Hydrocephalus is a condition that can develop for a variety of reasons, sometimes in conjunction with another disorder. Hydrocephalus that is congenital (present at birth) is thought to be caused by a complex interaction of genetic and environmental factors.   Aqueductal stenosis, an obstruction of the cerebral aqueduct, is the most frequent cause of congenital hydrocephalus.  The NS who did Jacobs shunt found old blood in the CSF and believes Jacob had a small hemorrhage before birth and this blocked his ventricules. It is a theory, he has no other medical conditions at all. Hydrocephalus is believed to occur in about 1.5 per 1,000 births.

Hydrocephalus that is acquired after birth may result from intraventricular hemorrhage, meningitis, head trauma, tumors or cysts or for no known reason. Hydrocephalus is believed to occur in about 1.5 per 1,000 births.

Normal Pressure Hydrocephalus (NPH) is a form of hydrocephalus that affects older adults. Sometimes the cause of NPH is known-and can include head trauma or brain tumor—but most often it is idiopathic, which means the cause is not known.

There is no known way to prevent or cure hydrocephalus. The most common treatment is surgical insertion of a shunt. A shunt is a flexible tube placed into the ventricular system of the brain which diverts the flow of CSF into another region of the body, most often the abdominal cavity, where it can be absorbed. A valve within the shunt regulates the flow of CSF. The shunt procedure is performed by a neurosurgeon. Shunts can become clogged or malfunction and surgical revisions are often required.  Jacob has a VP Shunt, it goes from his ventricles to his abdominal cavity. So far he has not had any problems with shunt, no malfunctions and no revisions. In fact it is possible his Hydrocephalus has resolved itself but the only way to know for sure would be to remove his shunt and as they say “no way Jose’”!!! why mess up something that is working just fine.

another option is Endoscopic Third Ventriculostomy (ETV) this is a procedure in which a small perforation is made in the thinned floor of the third ventricle, allowing movement of CSF out of the blocked ventricular system. It is a promising technique that can treat hydrocephalus without a shunt. ETV is not a cure for hydrocephalus and it is not an appropriate choice of treatment for many types of hydrocephalus. Each case must be evaluated individually by experienced medical professionals.

Hydrocephalus can affect cognitive, social and physical development and abilities in different ways in different people. Jacob was evaluated when he was 3 1/2 years old. He had a cognitive delay and minor and gross motor skills delays. The local school system set him up with an I.E.P. (individual education plan) He went 2 days a week for extra help with social development, and motor skills. He still has his IEP and will be going into 2nd grade next year. But hey are telling me he will phase out next year. He is reading a level above half of his class mates and is on level in math and writing. His social skills are also on level and he plays soccer. We tried tee ball but its not his thing. We still go once a year for a check up with his NS. So far so good. There are warning signs to look for in the future as he can always and at any time have a shunt malfunction. So we watch for the signs and they are vomitting, lethargy, headaches, poor balance. those are the main ones they can show one, all or none of them.

 

all the technical information found here was taken from: http://www.hydroassoc.org/  For more information please visit the site.