sailor girlAdult-Onset Hydrocephalus



Hydrocephalus is a neurological disorder in which there is excessive accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain. Most forms of hydrocephalus are the result of obstructed CSF flow in the ventricular system which may be caused by a birth defect, hemorrhage, viral infection, meningitis, a tumor, or head injury. In adults, symptoms of hydrocephalus include severe nausea and vomiting, migraine-like headaches, lethargy, difficulty waking or staying awake, seizures, visual impairment, irritability, and tiredness. Two forms of hydrocephalus--hydrocephalus ex-vacuo and normal pressure hydrocephalus (NPH)--occur most commonly in adults. Hydrocephalus ex-vacuo occurs when there is damage to the brain caused by stroke or injury, and there may be an actual shrinkage of brain substance. In old age or in individuals with Alzheimer's disease the entire brain may shrink and the CSF increases to fill up the space created by the shrinkage. NPH is caused by a gradual blockage of the CSF draining pathways in the brain. Although the ventricles enlarge, the pressure of the CSF remains within normal range. NPH is characterized by memory loss (dementia), gait disorder, urinary incontinence and a general slowing of activity.

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TREATMENT: Due to the multiple underlying disorders and conditions which result in hydrocephalus, there is often no permanent cure. The most effective treatment is the surgical insertion of a shunt-a flexible, artificial tube-into the ventricular system of the brain to divert the flow of CSF into another area of the body, where the CSF can drain and be absorbed into the bloodstream.

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PROGNOSIS: The prognosis of hydrocephalus is determined by the cause, the presence or absence of associated anomalies, and the timeliness of diagnosis and treatment. In some cases of NPH in which a shunt has been inserted to remove the excess fluid, the function of the brain may recover and the dementia may be reversed.

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RESEARCH: Studies are being done that explore the complex mechanisms of normal brain development. The knowledge gained from these fundamental studies provides the foundation for understanding how this process can go awry and, thus, offers hope for new means to treat and prevent brain disorders, including hydrocephalus.

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These articles, available from a medical library, may provide more in-depth information on hydrocephalus:

Benzel, E, Pelletier, A, and Levy, P. "Communication Hydrocephalus in Adults: Prediction of Outcome After Ventricular Shunting Procedures." Neurosurgery, 26:4; 655-660 (April 1990).

Masters, J, and O'Grady, M. "Normal Pressure Hydrocephalus -- A Potentially Reversible Form of Dementia." Journal of Psychosocial Nursing, 30:6; 25-28 (1992).

Scott, R (ed). Hydrocephalus. Volume 3: Concepts in Neurology, Williams & Wilkins Publishers, Baltimore, pp. 34-46, 109-114 (1990).

St-Laurent, M. "Normal Pressure Hydrocephalus in Geriatric Medicine: A Challenge." Journal of Geriatric Psychiatry and Neurology, 1; 163-168 (July- September 1988).

Turner, D, and McGeachie, R. "Normal Pressure Hydrocephalus and Dementia -- Evaluation and Treatment." Clinics in Geriatric Medicine, 4:4; 815-830 (November 1988).

Information may also be available from the following organizations (last updated April 7, 1998):

Hydrocephalus Association

870 Market Street, Ste. 955

San Francisco, CA 94102

(415) 732-7040

Nat. Hydrocephalus Fnd.

1670 Green Oak Circle

Lawrenceville, GA 30243

(770) 995-9570

Guardians of Hydro. Res. Fnd.

2618 Avenue Z

Brooklyn, NY 11235

(718) 743-4473

(800) 458-8655

Family Caregivers Alliance

425 Bush Street, Suite 500

San Francisco, CA 94108

(800) 445-8106 (toll free in CA)

(415) 434-3388

Nat. Easter Seals Society, Inc.

230 W. Monroe St., Ste. 1800

Chicago, IL 60606

(312) 726-6200

(800) 221-6827

Nat. Org. for Rare Disorders

P.O. Box 8923

New Fairfield, CT 06812-8923

(203) 746-6518

(800) 999-6673

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