Hydrocephalus (dropsy of the brain)

Hydrocephalus is an excess accumulation of cerebrospinal fluid (CSF) in the hollow spaces (ventricles) of the brain. The disease leads to excessive intracranial pressure and an increase in the size of the ventricles. In addition to intense headache, hydrocephalus is accompanied by neurological damage to the brain. The effectiveness of treatment depends on the stage and causes of the disease.

The diagnosis and treatment of hydrocephalus must be carried out in a clinic where there is a specialized neurosurgical department. Contacting the doctor-coordinator of MedTour will allow you to learn about modern methods of diagnosis and treatment of this disease.

Why does hydrocephalus occur

In official medicine, there is a classification of hydrocephalus, according to which it is divided into congenital and acquired. Depending on this, doctors determine the causes of the disease.

According to the WHO, about 700,000 children and adults worldwide are diagnosed with hydrocephalus. Congenital dropsy of the brain affects one in 500 babies.

Causes of congenital hydrocephalus

Hydrocephalus in the fetus can be associated with developmental problems of the central nervous system or with an intrauterine infection. Congenital dropsy of the brain is diagnosed less often than acquired. Usually, at the age of 6 months, pediatricians note that the child’s head circumference and shape is different from the norm (voluminous, elongated skull).

Dropsy of the brain in children is difficult. If high-quality diagnosis and treatment is not carried out at an early stage, hydrocephalus will lead to serious complications and developmental delay.

Causes of acquired hydrocephalus

In most cases, acquired hydrocephalus occurs as a result of past diseases:

• Meningitis – inflammation of the membranes of the brain and spinal cord of viral or bacterial etiology;
• Meningoencephalitis – inflammation of the substance and membranes of the brain;
• Sarcoidosis is a granulomatous lesion of the lining of the brain;
• Intraventricular hemorrhage – bleeding in the ventricles of the brain (with traumatic obstetric aid);
• Brain tumors.

Also, the causes of hydrocephalus can be craniocerebral trauma and other external factors.

Hydrocephalus symptoms

Hydrocephalus can manifest itself in different ways depending on the age of the patient and the stage of the disease. The most common symptoms of dropsy of the brain:

• Enlarged head and bulging fontanelle in infants;
• Headache that does not go away with rest or pain medication;
• Displacement of the eyeballs to the bottom;
• Vomiting with a feeling of mild nausea;
• Balance problems;
• Poor control of urination;
• Seizures;
• Weakness, feeling of constant fatigue.

Specific signs of hydrocephalus include:

• Increased irritability;
• Personality changes, not typical behavior;
• Thinking problems;
• Memory impairment.

Diagnostics of the hydrocephalus

To identify signs of hydrocephalus, first of all, a doctor’s examination is necessary. A neurologist may prescribe the following examinations:

• X-ray (to identify the divergence of the seams of the skull);
• Echoencephalography (determines pathological processes in the brain);
• Sonography (allows you to view the structures of organs);
• CT and MRI (determine developmental abnormalities and obstacles along the cerebrospinal fluid pathways);
• Lumbar puncture (for examining cerebrospinal fluid).

If hydrocephalus was diagnosed at a late stage and has pronounced clinical manifestations, then even a surgical operation does not guarantee a complete recovery.

How long do patients with hydrocephalus live

If hydrocephalus is not treated, the disease leads to serious disorders in the central nervous system, intellectual activity and even death. It all depends on the degree of brain damage due to increased intracranial pressure.

In medical practice, there have been cases when, with constant drug therapy (at the earliest stage), patients took drugs for 10-20 years and their health condition did not worsen.

At later stages, neurosurgical and reconstructive operations return a person to normal life without limiting its duration.

Hydrocephalus treatment methods

Doctors prescribe treatment for dropsy of the brain, depending on the reasons that cause disturbances in the circulation of cerebrospinal fluid. Options for conservative and surgical treatment are possible. The main goal is to eliminate the excess accumulation of cerebrospinal fluid in the skull.

Conservative treatment of hydrocephalus

Drug therapy is used to relieve symptoms and improve the quality of life of patients. However, doctors often prescribe diuretics.

If the symptoms are severe, then conservative treatment will help slow down the course of the disease, but will not eliminate its cause. The most effective method is surgery to restore CSF dynamics.

Surgical treatment of hydrocephalus

For congenital hydrocephalus, surgery is the key treatment. Doctors perform surgery if the patient is diagnosed with a tumor process in the brain, intracranial hematoma or abscess.

Bypass surgery (ventriculoperitoneal bypass surgery)

During the operation, the doctor implants a shunt system, which allows excess cerebrospinal fluid to be removed through a thin silicon tube from the brain to another part of the body (usually the abdominal cavity). From here, the fluid is absorbed into the bloodstream. The shunt consists of a catheter and a valve to control the rate of CSF outflow and to maintain normal intracranial pressure.

Ventriculoperitoneal shunting for hydrocephalus should be performed by an experienced neurosurgeon. To choose a suitable clinic and the best specialist in neurosurgery, leave a request on the MedTour website.

Examples of prices for bypass surgery for hydrocephalus treatment:

• Germany – from €7 900;
• Ukraine – from $6 000.

Endoscopic surgery

Endoscopy for hydrocephalus is one of the priority treatment methods in modern neurosurgery. Doctors use several types of surgical treatment with an endoscope:

• Aqueductoplasty – the surgeon makes holes in the skull and forms the fourth ventricle. It serves to drain the cerebrospinal fluid and implant an intraventricular stent to reduce the risk of recurrence;
• Septostomy – the neurosurgeon conducts the opening of the transparent septum inside the ventricle, for example, with cysts on it or blockage of the interventricular opening;
• Ventriculocostocisternostomy is an operation to ensure the outflow of cerebrospinal fluid into the cisterns of the brain.

Additional surgeries for hydrocephalus

In some cases, patients need additional surgical interventions. Such a need arises in the presence of concomitant diseases and severe deformity of the skull.

Craniotomy

A surgeon may do this for hydrocephalus to remove a brain tumor, a blood clot, and control blood flow from a weak blood vessel (aneurysm). The method can be used to restore arterial-venous anomalies, drain abscesses, relieve intracranial pressure and brain biopsy.

Examples of prices for craniotomy in clinics in different countries:

• Israel – from $24 000;
• Germany – from $21 400;
• Turkey – from $13 300.

Cranioplasty

This is a type of corrective surgery that a doctor performs after a craniotomy to restore the skull to its normal shape. Cranioplasty for hydrocephalus has aesthetic value and has a protective function for the brain after major surgery.

How much does hydrocephalus treatment cost

The final price for the treatment of hydrocephalus is formed based on the diagnostic procedures and treatment methods selected by the doctor. Each case is individual, therefore, the cost is influenced not only by the pricing policy of the clinic, but also by the entire range of medical decisions for the patient.

To find out the cost of therapy and surgical treatment of hydrocephalus in a particular clinic, leave a request on the MedTour website. The coordinating doctor will help you choose the best neurosurgeon and guide you on the prices for medical services.

Published: 07.07.2021

Updated: 29.07.2021

Medical expert:

PhD. Olexandr Voznyak

Medical author:

Ilona Baidiuk

Information on this webpage verified by the medical expert

Medical Doctor, oncologist, PHD student

Kateryna Maliarchuk