How Serious Is Hydrocephalus in Adults?

Hydrocephalus, also called “water on the brain,” is a neurological problem that entails an abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain.

While it is most well-known in infants, hydrocephalus in adults is a legitimate and underdiagnosed entity. Adult hydrocephalus varies in seriousness based on many factors, such as the underlying cause, early detection, and appropriate management.

It can result in major neurological damage, disability, and death if left untreated. With early treatment, however, most individuals can learn to cope with the condition and lead normal and productive lives.

Hydrocephalus in Adults

In normal brain function, cerebrospinal fluid circulates continually through ventricles and over top of the brain and spine, cushioning the neurological system, draining off wastes, and providing a balance of pressures.

When this process is blocked, excessive, or inadequately absorbed, hydrocephalus develops, creating elevated skull pressure. Elevated intracranial pressure can impair brain tissues and destroy function.

There are various forms of hydrocephalus in adults. Communicating hydrocephalus is present when CSF is not properly absorbed. Non-communicating hydrocephalus is due to a physical obstruction of CSF movement.

Another variety, normal pressure hydrocephalus (NPH), usually happens in older people and develops gradually with insidious symptoms.

How Dangerous Can It Be?

Hydrocephalus is not a trivial health concern—it’s an illness that, if not treated, can become increasingly disabling. It can affect mobility, memory, cognitive ability, and mood.

How quickly it’s diagnosed, or not diagnosed, adds to its severity. What begins with the inability to walk or slight forgetfulness can escalate to dementia-like symptoms, loss of autonomy, and physical immobility.

Acute hydrocephalus (sudden onset) can be fatal in hours or a matter of days due to sudden rises in intracranial pressure. With chronic hydrocephalus, particularly that in conditions such as NPH, months or a matter of years can elapse before full effects are felt, yet it can be every bit as dire if ignored.

Conclusion

One option is endoscopic third ventriculostomy (ETV), which involves creating an opening in the ventricles of the brain so that CSF can bypass an obstruction. It is usually reserved for some forms of non-communicating hydrocephalus and does not have the long-term hazards associated with shunt systems.

Dr. Naresh Kumar Damesha
Consulting Neurosurgeon