Who is at Greatest Risk for Developing Hydrocephalus?

Your brain floats in a wash of cerebrospinal fluid, about two-thirds of a cup, that cushions your brain, supplies nutrients from your blood and removes waste. This fluid washes through cavities called ventricles that reach deep into your brain. When the flow stops, and cerebrospinal fluid starts to collect, the climbing pressure can cause damage to brain tissue and affect the way it works.

This condition is called hydrocephalus, and while it can affect people of any age, it seems to favor infants and adults over 60. The consequences of hydrocephalus can be devastating, so understanding who may be most at risk improves the chances for prompt treatment when symptoms emerge.

September is National Hydrocephalus Awareness Month, making it a fitting time to learn more about the condition.

Causes of hydrocephalus

Since cerebrospinal fluid interacts with the bloodstream, the balance between production and absorption is crucial to proper brain function. When this balance is upset — that is, fluid is made faster than it leaves — pressure builds in the brain’s ventricles. There are three reasons why this imbalance may occur.

Obstructions are usually the cause of hydrocephalus, blocking movement of fluid between ventricles or into other spaces in the brain. Less often, an absorption issue prevents cerebrospinal fluid from being absorbed into blood vessels at the base of the brain. This is usually caused by inflammation of brain tissue, either from disease or injury. Finally, in rare cases, cerebrospinal fluid may be produced more quickly than normal, and faster than it can be absorbed.

Risk factors for developing hydrocephalus

Typically, the precise cause of hydrocephalus goes unknown, outside of traumatic brain injuries. Hydrocephalus may be present at birth due to abnormal development of the nervous system, bleeding within the brain’s ventricles (often a complication of premature birth), or infections present in the uterus that cause inflammation of fetal brain tissue. About 2 of every 1,000 babies are born with congenital hydrocephalus.

Acquired hydrocephalus can develop from tumors and lesions of the spinal cord or brain, causing obstructions to the flow of cerebrospinal fluid. Infections of the central nervous system may also be a culprit.

Diseases such as bacterial meningitis and mumps may cause inflammation in the brain. Bleeding in the brain, whether from stroke or head injury, also adds to fluid and pressure buildup.  

Preventive treatment of hydrocephalus

There are some steps you can take to reduce the risk of hydrocephalus. If you’re pregnant or planning a child, your doctor will screen for many factors that can contribute to hydrocephalus, such as clearing up high-risk infections and protecting against premature labor.

Vaccinations against infectious illness can also reduce the risk of conditions that support hydrocephalus. Review your vaccination schedule, or those of your children, to make sure you have the age-appropriate immunizations in place.

Proper use of safety equipment, whether driving or involving physical activity, can reduce your risk of head injury. This includes seat belts, child car seats, and head gear suitable for the activity you’re enjoying.

Hydrocephalus can be treated surgically, and the sooner you start treatment, the better the chances of avoiding complications. If you or a family member shows signs of hydrocephalus symptoms, seek medical attention immediately, or contact me at the Seattle Neuroscience Institute as soon as possible.

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