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What is it about ?
The brain and spinal cord are soft, fragile tissues that are protected from shock by cerebrospinal fluid. This fluid is produced in the cavities of the brain from the blood. It then circulates around the brain and spinal cord. Then he goes back to the blood. So there is a constant production and flow of cerebrospinal fluid and a balance between production and elimination.
We talk about hydrocephalus when there is too much cerebrospinal fluid in the brain. The pressure increases, which is very dangerous for the brain.
The flow of cerebrospinal fluid can be restored by placing a bypass or shunt. It is a kind of connection, through tubes, between the cavities that contain the cerebrospinal fluid (ventricles of the brain) and the belly cavity (ventriculo-peritoneal bypass). When there is a blockage at this connection, the pressure rises again in the brain.
Nowadays, other techniques are also used to treat hydrocephalus: an operation establishes a connection in the brain itself, so that the excess pressure is reduced. This connection can also become blocked and cause the same symptoms.
What is its frequency?
About 90% of all hydrocephalus cases (except tumors) happen before the age of one. The causes can appear before, during or after birth: they can be malformations, cerebral hemorrhages, infections.
How to recognize it?
Too much pressure in the brain can lead to headaches, fatigue, vomiting, crying, irritation, or painful movements of the head or eyes. The child eats with difficulty and his eyesight deteriorates. Seizures may occur and he may be less awake. If there is an infection, the child may also have a fever and generally feel unwell.
How is the diagnosis made?
The doctor performs a clinical examination. He checks for redness or swelling at the site of the shunt. In hydrocephalus, the fontanel stretches and the junctions between the bones of the skull are opened. Pressure on the brain makes eye movement difficult and the pupil may be slightly dilated (it no longer responds to light). The state of consciousness may drop and reflexes may be impaired. The doctor measures the head circumference, height and weight.
What can your doctor do?
If there are signs of hydrocephalus or an improperly functioning shunt, the doctor will immediately refer the child to the hospital. He will note the head circumference, height and weight on the reference letter.
It is necessary to act quickly in the event of fainting or respiratory arrest. The excess pressure must be remedied as much as possible before the child can be transported to the hospital because his condition can worsen very quickly. The emergency doctor will be able to remove 20-30 ml of cerebrospinal fluid.
A cerebrospinal fluid puncture (lumbar puncture) is prohibited if overpressure in the brain is suspected.
What can you do ?
Watch out for signs of excessive pressure in the brain and contact a doctor promptly if you suspect anything.
Want to know more?
- Hydrocephalus – better understanding the disease and its treatments – CHU Montreal
- Reduce the pressure in the skull with a drain – The external ventricular drain – CHU Montreal
- Caring for a loved one with a drain in the skull – The external ventricular drain – CHU Montreal
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