Replacement Hydrocephalus - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Replacement hydrocephalus

The main symptom of this disease is contained in the very name of the pathology - with replacement hydrocephalus, the substance of the brain gradually loses its volume and is replaced by CSF (cerebrospinal fluid). Hydrocephalus, or dropsy of the brain, is an excessive production or disturbance of the movement and absorption of cerebrospinal fluid by various structures of the ventricles and subarachnoid space. Most often, elderly patients suffer from hydrocephalus replacement. The disease requires mandatory comprehensive treatment.

Content:

• Causes of the disease
• Classification of forms of replacement hydrocephalus
• Symptoms and manifestations
• How is replacement hydrocephalus diagnosed?
• Replacement hydrocephalus treatment
• Prevention

Causes of the disease

The pathology is based on an imbalance between the production and absorption of cerebrospinal fluid, or the formation of an anatomical obstacle along the path of CSF circulation.

Factors triggering the pathological process:

• Inflammatory process in the tissues of the brain, as a result of neuroinfection (neurosyphilis, herpes, toxoplasmosis, rubella);
• Vascular pathology of the cerebral circulation system (aortic aneurysm, atherosclerosis);
• Cyst in the structures of the brain;
• Arterial hypertension;
• Alcoholism;
• Helminths parasitizing in brain tissues;
• Traumatic brain injury.

A small share of the causes of pathology is occupied by unexplained factors.

Classification of forms of replacement hydrocephalus

The manifestations of the disease take several forms:

• External replacement hydrocephalus is a classic variant of the development of the disease, the main symptom of which is a decrease in brain volume, filling the vacated space with cerebrospinal fluid;
• Internal replacement hydrocephalus - most of the cerebrospinal fluid accumulates in the ventricles of the brain, where it is actively produced by the vascular plexus of the blood vessels;
• Mixed hydrocephalus replacement - CSF overflows not only the ventricles, but also the subarachnoid space between the membranes of the brain.

Each form of hydrocephalus replacement occurs with characteristic symptoms. It does not compensate for it on its own; over time, symptoms of cerebral circulation disorders necessarily increase, therefore, at the first symptoms, consultation of a neurologist or neurosurgeon is required.

Symptoms and manifestations

Any form of hydrocephalus manifests its most striking symptoms as a violation of the functioning of the central nervous system. Most of the signs of this pathology are associated with an increase in intracranial pressure.

Possible manifestations of replacement hydrocephalus:

• Severe headache in the morning upon waking, caused by prolonged horizontal position of the body;
• Nausea and vomiting;
• Blood pressure surges;
• Tachycardia, arrhythmia;
• Lethargy and sleepiness during the day, sleeplessness at night;
• Increased fatigue, a decrease in the pace of doing familiar things;
• Irritability;
• Decreased visual acuity;
• Impaired coordination of movements, wobbly gait.

In the later stages of the disease, symptoms of dementia appear - memory lapses, absent-mindedness, impaired short-term memory, the inability to manipulate numbers, perform analysis and synthesis operations, and think logically. Epileptic syndrome becomes a severe complication of hydrocephalus replacement. The patient develops dementia, he may fall into a coma.

How is replacement hydrocephalus diagnosed?

It is difficult even for an experienced physician to make an accurate diagnosis of this disease based on the patient's complaints and visual signs.

For a complete examination, the following methods are used:

• Magnetic resonance therapy (MRI) is the most informative study that allows you to see the enlarged cavities of the ventricles of the brain, atrophic changes in its tissues, an increased volume of cerebrospinal fluid;
• Angiography - X-ray examination of cerebral vessels;
• Brain ultrasound;
• X-ray of the skull;
• Fundus ophthalmoscopy;
• Carrying out a PCR reaction to determine in the blood antibodies to the causative agents of herpes, toxoplasmosis, rubella, syphilis if an infectious cause of the disease is suspected.

If replacement hydrocephalus occurs in a moderate form with minimal signs, every 6 months you need to undergo an examination to timely detect the negative dynamics of the disease. With severe symptoms of increased intracranial pressure, treatment should be started immediately.

Replacement hydrocephalus treatment

The choice of treatment tactics depends on the severity of the symptoms of the disease and the degree of brain atrophy. Most often, conservative treatment is used, although in case of a complicated course, surgical intervention is possible.

The main directions of drug therapy in moderate form:

• Improving cerebral circulation;
• Decreased intracranial pressure;
• Improving the general condition of the body.

Treatment methods for hydrocephalus replacement:

• Physiotherapy;
• Taking nootropics - phenibut, cinnarizine, cerebrolysin, glycine;
• Taking diuretics to reduce the volume of cerebrospinal fluid - diacarb, mannitol, furosemide in combination with potassium and magnesium preparations;
• Massage of the temples and neck area;
• The use of medicinal baths;
• A diet using foods rich in trace elements (lettuce, spinach, nuts, bananas, dark chocolate).

Surgical treatment for hydrocephalus replacement is rarely performed, only with a sharp deterioration in the patient's condition.

To facilitate the patient's well-being, the neurosurgeon performs bypass surgery - the installation of an artificial pathway for the movement of the cerebrospinal fluid. The cavity of the ventricles is connected by a shunt with another cavity of the human body, which has the ability to absorb the excreted cerebrospinal fluid.

Most often, the shunt is taken out into the abdominal cavity. As soon as the intracranial pressure exceeds the norm, you can open the shunt valve and remove some of the fluid from the ventricles. The components of the bypass system need to be updated from time to time, because the patient's life depends on its trouble-free operation.

Another option for surgical intervention is endoscopic ventriculostomy, when the excess volume of cerebrospinal fluid is excreted through artificially created holes at the bottom of the ventricles of the brain.

Treatment of hydrocephalus replacement is carried out in a complex, in accordance with the individual characteristics of the patient.

Prevention

In order not to experience the symptoms of a disease that threatens serious consequences, you need to adhere to the following rules:

• Avoid infections, the complications of which lead to brain damage;
• Timely treat arterial hypertension;
• Avoid increasing intracranial pressure;
• Do not abuse alcohol, avoid exposure to neurotoxins.

Unfortunately, it is still impossible to avoid age-related changes at the present stage of development of medicine. The prognosis of replacement hydrocephalus, not related to age, is quite good - with timely treatment, the condition of the patients improves markedly.

Author of the article: Sokov Andrey Vladimirovich | Neurologist

Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".