Hydrocephalus

Hydrocephalus

Hydrocephalus (or 'water on the brain') develops when the fluid that is continuously produced in our brain is not drained properly. We all produce brain fluid in our head. Which is important, because that is why we can move our head without suffering from a concussion. Each day we produce over half a liter of brain fluid in our head. Normally this fluid will enter into our blood circulation. Yet if there is an obstacle somewhere, the amount of fluid in the brain will continue to increase.

Consequences

In small children the skull is still flexible. It causes the head to hugely expand in case of Hydrocephalus. When the pressure of the fluid on the brain becomes too much, it goes from bad to worse: the child develops spasms, goed blind, and could die.

Why is hydrocephalus so common in developing countries?

Hydrocephalus can be related to spina bifida, but there are other causes as well, such as brain haemorrhage, infections, and tumors. In developing countries the main causes are poor treatment of meningitis, brain haemorrhage due to low birth weight, or giving birth in poor hygienic circumstances.

How can hydrocephalus be treated?

Hydrocephalus can be treated by draining the accumulated fluid in the brain. Usually this is done by placing a shunt, a cilinder implanted in the head which drains the fluid beneath the skin to the diaphragm. Placement of the shunt is a relatively simple procedure, although there are of course risks involved, especially in developing countries, with regard to infections. The cost of a shunt in our country varies between 800€ and 1600€. That is why we use the Indian Chhabra shunt of 45 euro in our projects. Comparative research showed no differences in results between these shunts.

An alternative method of treatment is endoscopic third ventriculostomy (ETV). This is an endoscopic intervention to create a natural bypass in the floor of the third ventricle. It allows the superfluous fluid to flow down and be absorbed. If the hydrocephalus is caused by an obstruction, this obstruction can be endoscopically removed. To use this method, the absorption mechanism needs to be functioning well. ETV is safer and sustainable because shunt complications are prevented.

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