Accumulation or increase of water in the head causes hydrocephalus. Stating that there are many causes of hydrocephalus, experts state that a tumor that occurs in the place where the cerebrospinal fluid is produced can lead to excessive fluid production, and that an obstacle formed during circulation can also cause the disease. While experts emphasize that every individual is at risk of hydrocephalus from birth to the geriatric period, they recommend paying attention to symptoms such as impaired consciousness, developmental delay, and deterioration of eating patterns, especially in children, since they cannot express headaches. Üsküdar University NPİSTANBUL Brain Hospital Brain, Nerve and Spinal Cord Surgeon Prof. Dr. Mustafa Bozbuğa made evaluations about hydrocephalus, which occurs when water accumulates in the brain.
Increased water can lead to hydrocephalus
Stating that hydrocephalus literally means 'water head', Prof. Dr. Mustafa Bozbuğa, “Hydrocephaly is the accumulation or increase of water, that is, cerebrospinal fluid, in the head. Under normal conditions, roughly 80% of the inside of the head is made up of brain tissue, 10% is cerebrospinal fluid, and 10% is blood. Cerebrospinal fluid has many functions such as mechanical protective and nourishing. Cerebrospinal fluid has a continuous circulation within and from the surface of the brain and spinal cord, reaching the starting point of the nerves, in a constantly sensitive dynamic of production, circulation and absorption. Sometimes, stenosis may occur in this circulation path of the spinal fluid due to congenital anomaly, tumor occurring after birth or other reasons. Since the path narrows, cerebrospinal fluid accumulates in the part behind the path. This is one of the types of hydrocephalus.” said.
Not defined as a disease in every person
Stating that the cerebrospinal fluid in an average adult is 150 cc and the daily production and absorption is about 500 cc, Prof. Dr. Mustafa Bozbuğa said, “Half of this fluid is in the head and half is in the spinal cord. In some people, this rate may be different for various reasons. We do not define this condition directly as a disease in every person. For this condition to be considered a disease, the cerebrospinal fluid-filled ventricles must have higher-than-expected pressure and put pressure on the brain. Conditions that are considered normal are defined as ventriculomegaly. Some people have a somewhat large ventricle inside their head, and that doesn't always mean disease." he said.
The result of tissue loss can be dangerous
prof. Dr. Mustafa Bozbuğa said that when hydrocephalus occurs in some people, the pressure rises and there is pressure in the brain, and he continued as follows: “However, the body can adapt to this and create a balance over time. With the increasing pressure of the cerebrospinal fluid, the brain tissue, which is under pressure, may reduce its volume a little, that is, there is a loss of brain tissue. This is a pathological process, but the person's body can use this mechanism to maintain life. In other words, tissue loss occurs, but as a result of the process, normal pressure and balance is reached in the head. As a result of the situation, there is no disease, and in this case, the sequelae of the disease, which means the remainder of the disease, occurs. These situations do not require any intervention. When there is pressure on the brain in hydrocephalus, the body's protective mechanisms may not always be sufficient and the situation can sometimes pose a life-threatening risk. Therefore, it is necessary to urgently intervene in the situation before its permanent and harmful effects occur, that is, when the hydrocephalus is in its more active period.”
Tumor can lead to fluid accumulation
Emphasizing that there are many causes of hydrocephalus, Prof. Dr. Mustafa Bozbuğa said, “Under normal conditions, a certain amount of cerebrospinal fluid is produced and a certain circulation is maintained and the same amount of cerebrospinal fluid is absorbed. At any point in this process, a problem that occurs in the production, circulation and absorption stages of the fluid can cause hydrocephalus. For example, a tumor that arises where cerebrospinal fluid is produced can lead to excess cerebrospinal fluid production. An obstacle that occurs during circulation is one of the causes of hydrocephalus. Occlusion of the circulatory pathway is mostly caused by tumors or developmental anomalies. Another cause is malabsorption of cerebrospinal fluid; this usually occurs as a result of bleeding or inflammatory processes. Thus, hydrocephalus disease can occur at any age, for different reasons, with different clinical manifestations, with different course and outcome.” used the phrases.
Can be diagnosed while in the womb
Stating that there are three different rings in the formation mechanism of hydrocephalus, Prof. Dr. Bozbuğa said, “Not only one of these three different stages, namely the production, circulation and absorption of the cerebrospinal fluid, but more than one factor can act at the same time. For example, in a subarachnoid hemorrhage, there may be both obstruction in the pathway and insufficiency in absorption, or in the case of a tumor, both increased production and narrowing of the cerebrospinal fluid on the circulation path and impaired absorption may develop. This type of mechanism disorders can occur due to pathologies affecting almost all kinds of nervous system. Its occurrence may be congenital, due to infection, tumor-related, intoxication or other causes. Therefore, hydrocephalus can be diagnosed from the mother's womb.” said.
Attention should be paid to symptoms in children
prof. Dr. Mustafa Bozbuğa said that the diagnosis of hydrocephalus can last until the geriatric age and continued his words as follows: “However, the causes and manifestations of hydrocephalus differ according to age. The same mechanisms can be found in structurally occurring hydrocephalus. Among the symptoms of hydrocephalus, headache, nausea, vomiting, consciousness disorders, behavioral disorders, gait disorders, regression and weakening in higher cortical functions, namely memory, decision making and abstract processes, can be found as a result of the increase in pressure in the head and in the brain. However, if it occurred as a secondary condition with a primary disease, there will also be manifestations of the primary disease. Hydrocephalus is more difficult to detect in children. As a matter of fact, a child within the age of 1 will not be able to express a headache. However, symptoms such as irritability, crying, growth in the head, deterioration of eating patterns, impaired consciousness and developmental delay in children may suggest this diagnosis.
The most important treatment is the 'Shunt Method'
Emphasizing that hydrocephalus can be seen in individuals of all ages, from intrauterine life to the latest period of life, Prof. Dr. Mustafa Bozbuğa, “Hydrocephaly does not have an external trigger related to lifestyle. Undoubtedly, we can say that the treatment of hydrocephalus is possible, depending on its cause and degree. The treatment of hydrocephalus also varies according to the cause and there are different possibilities; For example, in a tumor-induced hydrocephalus, removal of the tumor alone may often be sufficient. Endoscopic methods are used in some patients, but the most commonly used surgical treatment is the transfer of excess cerebrospinal fluid in the head to another place in the body, which is the basis of the treatment we call "shunt surgeries". Cerebrospinal fluid is often transferred from chambers within the brain (ventricle) to the intra-abdominal cavity (peritoneum). said.