Hydrocephalus is the abnormal buildup of cerebrospinal fluid (CSF) within the cavities surrounding the brain. The condition, also known as water on the brain, causes an increase in intracranial pressure within the skull and results in the dysmorphic expansion of the head.
One to two of every 1,000 babies are born with hydrocephalus, making it as common as Down’s syndrome and more common than spina bifida or brain tumors.
In a person without hydrocephalus, CSF continuously circulates through the brain, the ventricles, and the spinal cord and is regularly drained into the circulatory system.
Hydrocephalics suffer with the fluid not draining properly either from a blockage in the ventricles or subarachnoid space. Additionally they can have an overproduction of the CSF, a congenital malformation inhibiting normal drainage or circulation, or develop the condition from complications related to head injuries or infections.
Based on the underlying cause, hydrocephalus can be classified into communicating and non-communicating (obstructive). Both forms can be either congenital or acquired.
Infants with hydrocephalus, CSF builds up in the central nervous system, causing the fontanelle (soft spot) to bulge and the head enlarge.
Along with the obvious swelling, other symptoms include seizures, vomiting, excessive fatigue, headaches, muscle spasms, uncontrolled eye movements, and irritability. Prolonged, sustained pressure from the cranial distention can result in brain damage and blindness.
Hydrocephalus is treated surgically. Various types of cerebral shunts are implanted and used to circumvent the flow of the CSF. A ventricular catheter is placed into the cerebral ventricles to bypass the obstruction or malfunction and drains the excess fluid into other body cavities where it can be reabsorbed.
An alternative treatment for obstructive hydrocephalus is the endoscopic third ventriculostomy (ETV), whereby a surgically created opening in the floor of the third ventricle allows the CSF to flow directly to the basal cisterns, short-cutting the obstruction.
Recently worldwide attention was focused on little Runa Begum (named in other reports as Roona), of India, an 18-month-old who was born with an extreme case of hydrocephalus.
Similar to the 2012 reported case of three-year-old Dilla Anargia Adilla of Bogor, Indonesia, doctors in the Tripura region, where Runa’s family lives in India, have been unable to provide relief for the painful condition.
A 30 minute surgical procedure, costing between $300 and $1,200 per shunt could be performed but Abdul Rehman, the child’s father, doesn’t earn enough as a brick factory laborer to pay for medical intervention. He earns less than $3 a day.
[Image via Wikicommons Hydrocephalic Cranium of 25 year old Man, Otis Historical Archives of “National Museum of Health & Medicine”]