The MIT Braintrust Center for Neurological Disorder Information

Adult-Onset Hydrocephalus

Hydrocephalus (Greek roots: hydro (water), cephalus (head)), is a condition involving the abnormal accumulation of cerebrospinal fluid (CSF) in cavities of the brain known as ventricles. CSF is normally produced in the ventricles and circulates through the ventricular systems until it is absorbed in the bloodstream. The fluid supplies nutrients and proteins to the brain and carries waste tissues away from brain cells.

 Part 1: General Information
 Part 2: Self-Help
 Part 3: Further Information

I. General Information

A patient with hydrocephalus cannot absorb CSF as quickly as his or her brain produces the fluid. A build-up of CSF results, increasing pressure in the head as the ventricles enlarge. Genetic and environmental factors are thought to contribute to the condition when it is present at birth (congenital hydrocephalus). Other patients often acquire the disease after an obstruction of the cerebral aqueduct (aqueductal stenosis), which can result from spina bifida, intraventricular hemorrhage, meningitis, head trauma, tumors and cysts.
Adults with hydrocephalus may experience nausea and vomiting, migraine-like headaches, lethargy, difficulty waking or staying awake, seizures, visual impairment, irritability, or tiredness. Adults generally acquire one of two forms of hydrocephalus: hydrocephalus ex-vacuo or normal pressure hydrocephalus (NPH). Hydrocephalus ex-vacuo can accompany brain damage caused by stroke or injury. It can result in brain shrinkage, particularly in individuals with Alzheimer's disease. NPH, on the other hand, results from gradual blockage of the CSF draining pathways in the brain. Although the ventricles enlarge during NPH, the pressure of theCSF remains within normal range. Memory loss (dementia), gait disorder, urinary incontinence and a general slowing of activity are all symptoms of NPH.
Although, to date, there is no way to prevent or cure hydrocephalus, surgical insertion of a shunt, or flexible tube, into the ventricular system of the brain can diverts the flow of CSF into another region of the body (often the abdominal cavity or a chamber of the heart) where it can be absorbed. Surgeons adjust the valve within the shunt to maintain the CSF at normal pressure within the ventricles.
Many people who have received a shunt have progressed well, although some children with hydrocephalus have less than normal intelligence, physical disabilities, and some other medical problems. Some NPH patients receiving shunt-therapy have recovered full brain activity and dementia accompanying their condition has been reversed. Patients should inquire about shunt malfunctions and infections, developmental delays, learning disabilities and visual problems associated with the procedure.
 

II. Self-help

                         Hydrocephalus Association
                         870 Market Street, Ste. 955
                         San Francisco, CA 94102
                         (415) 732-7040

                         National Hydrocephalus Fnd.
                         Debbi Fields
                         12413 Centralia
                         Lakewood, CA 90715-1623
                         (562) 402-3523
                         hydrobrat@earthlink.net
                         debbifields@nhfonline.org 
                         www.nhfonline.org

                         Guardians of Hydro. Res. Fnd.
                         2618 Avenue Z
                         Brooklyn, NY 11235
                         (718) 743-4473
                         (800) 458-8655

                         Family Caregivers Alliance
                         425 Bush Street, Suite 500
                         San Francisco, CA 94108
                         (800) 445-8106 (toll free in CA)
                         (415) 434-3388

                         Nat. Easter Seals Society, Inc.
                         230 W. Monroe St., Ste. 1800
                         Chicago, IL 60606
                         (312) 726-6200
                         (800) 221-6827

                         Nat. Org. for Rare Disorders
                         P.O. Box 8923
                         New Fairfield, CT 06812-8923
                         (203) 746-6518
                         (800) 999-6673

The Neurology and Neuroscience Forum: http://www.medhelp.org/mhli/regcheck.exe?nxtpage=/perl6/neuro/wwwboard.html

Hydrocephalus: A Guide for Patients, Families & Friends:
http://www.oreilly.com/catalog/hydro/index.html

The Cleveland Clinic Hydrocephalus Project:
http://www.neus.ccf.org/Hydroceph/

An incredible list of self-help links are available on this site:
Hydrocephalus Index:
http://www.wfubmc.edu/bgsm/surg-sci/ns/hyceph.html
 

III. Further Information

                         Benzel, E, Pelletier, A, and Levy, P. "Communication Hydrocephalus
                         in Adults: Prediction of Outcome After Ventricular Shunting
                         Procedures." Neurosurgery, 26:4; 655-660 (April 1990).

                         Masters, J, and O'Grady, M. "Normal Pressure Hydrocephalus -- A
                         Potentially Reversible Form of Dementia." Journal of Psychosocial
                         Nursing, 30:6; 25-28 (1992).

                         Scott, R (ed). Hydrocephalus. Volume 3: Concepts in Neurology,
                         Williams & Wilkins Publishers, Baltimore, pp. 34-46, 109-114
                         (1990).

                         St-Laurent, M. "Normal Pressure Hydrocephalus in Geriatric
                         Medicine: A Challenge." Journal of Geriatric Psychiatry and
                         Neurology, 1; 163-168 (July- September 1988).

                         Turner, D, and McGeachie, R. "Normal Pressure Hydrocephalus and
                         Dementia -- Evaluation and Treatment." Clinics in Geriatric
                         Medicine, 4:4; 815-830 (November 1988).
 

 MIT Braintrust Center for Neurological Disorder Information