Adult-onset Hydrocephalus
Hydrocephalus literally means "water on the brain." In this disorder, excessive fluid accumulates in the brain, causing a variety of troubling symptoms. While some cases of adult-onset hydrocephalus result from a pre-existing congenital defect, most are acquired as a result of trauma, tumor, infection or hemorrhage. The condition is most common in adults over the age of 60. Because this disorder most often occurs later in life, and because many of the symptoms of adult-onset hydrocephalus are the same as those associated with aging or early dementia, some patients may be initially misdiagnosed or may misdiagnose their own condition.
Causes of Adult-onset Hydrocephalus
While occasionally adult-onset hydrocephalus results from a congenital defect discovered later in life, other factors are most often the cause. There are three reasons for excessive the buildup of cerebrospinal fluid in the brain: too much is produced, its flow is blocked, or it is not absorbed properly. Causes for such abnormal buildup include:
- Infections, most frequently bacterial meningitis
- Aqueductal stenosis that blocks the flow of cerebrospinal fluid
- Hemorrhage resulting from trauma or cerebral aneurysm
- Brain tumor
One type of adult-onset hydrocephalus, normal pressure hydrocephalus, typically occurs in older patients. In this form of the disorder, patients do not present with the high intracranial pressure characteristic of most hydrocephalic patients. Although NPH may be caused by a tumor, blockage or infection, in most cases it is idiopathic, meaning it results from unknown causes.
Symptoms of Adult-onset Hydrocephalus
The first signs of adult-onset hydrocephalus are often difficulty walking and standing, and a perceptible disturbance in the patient's gait. Other symptoms may include:
- Headaches
- Nausea or vomiting
- Lethargy
- Sleepiness
- Partial loss of vision
- Difficulty focusing
- Sudden falls
- Personality changes
- Seizures
Symptoms of normal pressure hydrocephalus include cognitive difficulties, such as confusion and memory loss, as well as urinary incontinence. These symptoms are often misdiagnosed as symptoms of early signs of Alzheimer's disease or another type of dementia. Definitive diagnosis of adult-onset hydrocephalus is made through the use of imaging tests, such as a CT scans, MRI scans or ultrasounds, or through the use of devices that measure intracranial pressure.
Treatments for Adult-onset Hydrocephalus
Treatment for adult-onset hydrocephalus involves placing a shunt within the ventricular system of the brain to help drain excess fluid into another area of the body where it can be easily absorbed, usually the abdomen. This is done through a surgical procedure that creates small holes in the skull and abdomen between which an internal catheter is inserted to ensure proper drainage.
Complications of Treatment for Hydrocephalus
Shunt systems, while wonderfully beneficial in restoring quality of life to hydrocephalic patients, are not free of risk. Mechanical failures are possible, and it is sometimes necessary to have surgical intervention to lengthen or replace the catheter. Obstructions or infections may also occur. Patients with adult-onset hydrocephalus require ongoing medical monitoring to remain in good health.
Recovery from Adult-onset Hydrocephalus
Although patients may experience temporary improvements, left untreated, symptoms of adult-onset hydrocephalus usually worsen over time, so early intervention is important. With early diagnosis and treatment, patients have the best chance of recovering from disabling symptoms and resuming a normal life. While treatment with shunts is not a cure, for some people it provides almost complete relief from symptoms. Exciting research is presently being done in an attempt to find a cure this disorder.