Communicating hydrocephalus is a medical condition in which there is too much cerebrospinal fluid (CSF) in and around the brain. As CSF builds up, pressure within the skull can lead to headaches, vision problems, and impaired cognitive abilities. The condition can become life-threatening if it is not diagnosed and treated right away. Surgery is necessary in most cases of communicating hydrocephalus to remove excess CSF and reduce the risk of complications.
Unlike most other forms of hydrocephalus, the communicating variety is not caused by an obstruction or narrowing in a CSF passageway. Instead, the ventricles in the brain allow CSF to flow freely, or communicate, between one another. The problem is that the brain does not reabsorb CSF normally, leading to an excess buildup. Many different factors can contribute to poor absorption, including chronic meningitis, severe head trauma, and brain aneurysms. In addition, an inherited condition that causes too much CSF to be produced may also lead to communicating hydrocephalus.
The symptoms of communicating hydrocephalus can vary depending on a person's age and the severity of intracranial pressure. Infants who are born with the condition are likely to have larger-than-average heads, irritability, and difficulties feeding. Young children may experience frequent bouts of vomiting, vision problems, delayed physical growth, and lowered mental capacity. When communicating hydrocephalus afflicts an adult, he or she might have frequent headaches, blurry vision, neck pain, and difficulties concentrating. Left untreated, hydrocephalus may result in a loss of consciousness, coma, or death.
It is important to seek medical care at the first signs of communicating hydrocephalus. A primary care or emergency room doctor can evaluate symptoms, ask about medical history, and refer the patient to a neurologist for further testing. The specialist may take computerized tomography scans and magnetic resonance imaging tests to look for signs of pressure buildup and physical abnormalities. A sample of CSF may need to be drawn through a surgical procedure and analyzed in a hospital laboratory to confirm a diagnosis.
Once doctors are certain that hydrocephalus is related to absorption problems and not a physical defect, they can determine the best course of treatment. The most common surgical procedure involves the insertion of a tube called a lumboperitoneal shunt into the lower back. The shunt carries excess CSF from the spinal column into the abdominal cavity where it can be absorbed by body tissue instead of brain tissue. In addition, a patient may be prescribed medications to fight infection and reduce the production of new CSF. Treatment is successful in relieving symptoms in most cases, though patients typically need to attend regular checkups throughout their lives to monitor their health.