What Are the Causes of Water on the Brain?
Water on the brain is the casual term for hydrocephalus, from the Greek words meaning "water" and "head." It occurs when cerebrospinal fluid (CSF) is blocked in the brain, causing an increase in pressure and swelling of the head. Hydrocephalus can be congenital, meaning present at birth, or occur later in life. There is no way to prevent hydrocephalus, and while there is no cure, there are two treatments available to relieve the pressure of built-up CSF.
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Circulation of CSF
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CSF is produced in the ventricles of the brain, small spaces in the center of the brain near the thalamus. It circulates through the ventricles and around the brain within the arachnoid space, which is a space between protective layers of the brain. It is then reabsorbed into the bloodstream.
CSF cushions the brain and lessens the effect of gravity. It also provides some protection from blows to the head by keeping the brain from banging against the skull.
Causes of Hydrocephalus
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Congenital hydrocephalus can be caused by genetic or environmental factors. One common cause is aqueductal stenosis, in which the cerebral aqueduct--a narrow passageway that drains CSF from the third ventricle into the fourth ventricle--is blocked or narrowed. Congenital hydrocephalus occurs in 1.5 out of every 1,000 births.
Hydrocephalus that occurs after birth may be caused by meningitis, head trauma, tumors, cysts, intraventricular hemorrhage or may be idiopathic, meaning the cause is unknown. -
Treatments
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The most common treatment for hydrocephalus is a shunt. A shunt is a tube that leads from a ventricle in the brain down to another part of the body where the CSF can be drained, usually either the heart or the abdomen. Shunts are permanent and sometimes have to be repaired if they become blocked. It may contain a valve that regulates the flow of CSF.
A newer alternative treatment is called ETV, for endoscopic third ventriculostomy. In this procedure, a hole is cut into the floor of the third ventricle in the brain, allowing CSF to bypass the blocked ventricles and flow into the interpeduncular cistern to continue its normal flow around the brain. ETV is not effective for every case of hydrocephalus--it depends heavily on where the blockage is and what caused it--but it is a new technique that does not require a shunt or valve.
Symptoms
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In infants, the symptoms of hydrocephalus are an enlarged head, a bulging "soft spot" or fontanel, vomiting, irritability, seizures and eyes fixed downward ("sunsetting of the eyes") in which the whites are visible above the iris. While the fusing of cranial bones means an adult's head can't swell, most of the symptoms for adults are similar, and can also include dizziness or loss of balance, incontinence, confusion and change in personality.
Complications
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If hydrocephalus is caught right away, the chances for a normal life and normal intelligence are high. If the condition is quite advanced at birth, then physical and mental disabilities are nearly certain.
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