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Normally, the brain and spinal cord (central nervous system) is surrounded by cerebrospinal fluid, or CSF. This fluid has several essential functions, which include transporting nutrients and waste, protecting the central nervous system, and providing buoyancy.
But sometimes, the amount of CSF in the central nervous system builds up, increasing pressure and causing damage to the brain tissue. This condition is called hydrocephalus, or water on the brain.
A patient can have hydrocephalus if her body produces too much cerebrospinal fluid, if the flow of the CSF is impaired, or if the body does not properly absorb the CSF.
To diagnose water on the brain, the physician will use several different neurological evaluations and scans. For example, with the neurological examination, the physician will check the patient’s hearing, coordination, reflexes, muscle strength and muscle tone.
The neurological examination will also look at the patient’s mood, balance, mental status, sense of touch, vision and eye movement. The physician may also use different scans to see the enlargement of the ventricles in the brain. Options include an ultrasound, computerized tomography and magnetic resonance imaging.
The MayoClinic.com noted that an ultrasound may detect water on the brain in babies before they are born. If a child is getting a CT or MRI to diagnose water on the brain, the physician may give her a mild sedation. However, CT scans are usually for emergency cases.
Two surgical options are often used to treat water on the brain: shunt and ventriculostomy. The National Institute of Neurological Disorders and Stroke noted that the most common treatment is a shunt system, in which the extra CSF is redirected to another part of the body where it can be absorbed.
With the shunt system, a catheter is place either in the cerebrospinal fluid outside of the spinal cord or in one of the ventricles in the brain. The other end of that catheter is put in the patient’s abdominal cavity. The valve in the shunt system regulates the flow of the CSF drainage.
Another surgery option to treat water on the brain is a ventriculostomy, in which the surgeon uses a camera to view the area where a tiny hole is made that will relieve the excess CSF. The surgeon uses a small tool to make a hole either between the ventricles or in the bottom of one of the ventricles. This hole allows for the excess CSF to drain out of the brain.
Side effects may occur with these different surgeries. For example, some patients may have a recurrence of their original water on the brain symptoms.
Vision problems, headaches, fever and irritability may occur. With a shunt system, redness or tenderness of the skin may occur. When a patient has a shunt valve in her abdomen, she may have abdominal pain. Other side effects include drowsiness, nausea and vomiting.
References
MayoClinic.com. Hydrocephalus. Web. 30 December 2011
http://www.mayoclinic.com/health/hydrocephalus/DS00393/METHOD=print
MedlinePlus Medical Encyclopedia. Hydrocephalus. Web. 30 December 2011
http://www.nlm.nih.gov/medlineplus/ency/article/001571.htm
National Institute of Neurological Disorders and Stroke. Hydrocephalus Fact Sheet. Web. 30 December 2011
http://www.ninds.nih.gov/disorders/hydrocephalus/detail_hydrocephalus.htm
Reviewed December 30, 2011
by Michele Blacksberg RN
Edited by Jody Smith
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