Hydrocephalus : A Rare Giant Head Syndrome

Roona Begum, a 18- month old girl in Tripura, suffers from Hydrocephalus. Hydrocephalus is a rare giant head syndrome which is a treatable disorder, causes fluid to build up in the brain and results in swollen head.  The condition of the little girl has resulted in her head swelling to a circumference of 91- centimeters (36-inches). This swollen head puts a lot of pressure on her brain and making it impossible for her to sit upright or crawl on the ground.

 Indian girl with hydrocephalus
Indian girl with hydrocephalus

The case is extremely rare, and the most common treatment involves the surgical insertion of a mechanism to drain cerebro-spinal fluid away from the brain and towards another part of the body where it can be easily absorbed into the bloodstream.

Fortis health care has come forward to help and offered a life-saving treatment, which her parents are unable to afford. Fortis will do an MRI to check the condition of Roona’s brain.  Fortis operates 76 hospitals in 11 countries, owns a charitable trust which will carry out this surgery free of charge.

Sandeep Vaishya, a leading neurosurgeon, also pledged to examine the girl and promises to do a surgery if possible.

It has been estimated that one in every 500 children suffers from hydrocephalus, a study conducted by the US government’s National Institute of Neurological Disorders and Strokes.

hydrocephalus
Hydrocephalus

Overview

The condition in which there is an excessive accumulation of fluid in the brain is known as Hydrocephalus ( water on the brain). A lot of pressure is done on the tissue of the brain, caused by the accumulation of excessive fluids which creates space in the brain termed as ventricles. If not treated on time, hydrocephalus can be very harmful. The excessive fluid is known as cerebro-spinal fluid (CSF) which surrounds the spinal cord and the brain. This dangerous disease can involve a large number of people of any age .

Hydrocephalus Conditions in Adolescent Children

  • Congenital defects
  • Infections affecting the central nervous system
  • Injuries caused at different stages of childbirth
  • Infections caught before birth
  • Injuries caused by subarachnoid hemorrhage
  • Nervous system tumors
Hydrocephalus Conditions
Hydrocephalus Conditions

Hydrocephalus Conditions in Older Children

  • History of developmental or congenital defects
  • Central nervous system infections
  • Injury
  • Bleeding anywhere in the brain
  • Tumors of the brain or spinal cord

Symptoms of Hydrocephalus

The signs and symptoms vary by age group and disease progression.

Symptoms in Infants

  • A rapid increase in the size of the head
  • Vomiting
  • An unusually large head
  • Irritability
  • Seizures
  • Developmental delay
  • A bulging ‘soft spot’ on the top of the head
  • Eyes fixed downward
  • Sleepiness
Symptoms of Hydrocephalus
Symptoms of Hydrocephalus

Symptoms in Older Children

  • Memory loss
  • Eyes fixed downward
  • Headache followed by vomiting
  • Urinary incontinence
  • Nausea
  • Blurred or double vision
  • Sluggishness or regression of development
  • Confusion
  • Irritability
  • Changes in personality
  • Impaired performance in school or work

Types of Hydrocephalus

  • Communicating Hydrocephalus : In this type, cerebro-spinal fluid (CSF) cannot circulate properly. The flow is normal between the four ventricles but is blocked after it leaves from  the ventricles.
  • Acquired Hydrocephalus : This type generally happens in the later stage of the life, may be due to any ailment and it can prove dangerous to the people of any age.
  • Congenital Hydrocephalus : It can cause by other environmental influences during fetal development. Congenital hydrocephalus can occur before, during or soon after birth.
  • Non- Communicating Hydrocephalus : Also known as Obstructive Hydrocephalus, It generally happens when the CSF flow is blocked in the multiple contracted pathways connecting the ventricles and as a result of which the flow of the CSF is not circulating accurately.
  • Normal Pressure Hydrocephalus (NPH) : The types are-

1)       Diopathic NPH : It generally happens because of some unidentified reason.

2)       PH of Known Cause : It is a result of tumors, surgery or the infections of head distress.

 

Causes of Hydrocephalus

The causes are not entirely clear to the scientist and the condition may result from genetic inheritance or developmental disorders. Other possible causes include :

  • Subarachnoid hemorrhage blocking the exit from the ventricles to the cisterns and eliminating the cisterns themselves.
  • Conditions such as tumors, meningitis or traumatic head injury
  • Complications associated with premature birth
Causes of Hydrocephalus
Causes of Hydrocephalus

Medical Tests for Hydocephalus

  • Transillumination of the head (shining a light against the head)
  • Head CT scan.
  • Scanning of Brain by using radioisotopes.
  • X-rays of the skull.
  • Arteriography.
  • Echoencephalogram (ultrasound of the brain ).
  • Spinal taps and examination of the CSF (rarely done)

Hydrocephalus Treatment

Hydrocephalus treatment is done to decrease the brain damage by circulating the better flow of CSF. A surgical procedure can eliminate the blockage. Sometimes a shunt is also placed covering the region of the blocked area within the brain to allow the flow of CSF.

Hydrocephalus Treatment
Hydrocephalus Treatment

Types of Hydrocephalus Surgery

  • Shunt Placement
  • Ventriculostomy
  • Endoscopic Ventriculostomy
Hydrocephalus Surgery
Hydrocephalus Surgery

Cost of Hydrocephalus Surgery in India

India is known for its high class and low cost medical and health care services. The hydrocephalus surgery is very cost-effective in Indian hospitals. Most of the hospitals are internationally accredited and provides a level of care equal to or exceeding that found in other developed countries of the world.

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