Recognizing Hydrocephalus as a Congenital Abnormality in Children

Hydrocephalus is a condition where there is an accumulation of brain fluid (cerebrospinal fluid) in the ventricular system which can be caused by over-production, distribution/flow disorders, or suboptimal absorption of the brain fluid. Under normal conditions, brain fluid is produced by the coroid plexus which will then be drained and absorbed to provide nutrition to the brain and spinal cord. However, in the case of hydrocephalus, due to certain causes, the balance between production-flow-absorption does not occur as it should, resulting in a buildup of brain fluid and the effect of increasing intracranial pressure.
The causes of hydrocephalus can generally be categorized into 2, namely congenital hydrocephalus (congenital) and non-congenital hydrocephalus (infection, bleeding, tumor). Especially in pediatric patients, hydrocephalus generally occurs due to congenital abnormalities. Data shows that around 40% of children's cases treated in the field of neurosurgery are hydrocephalus. The most common cause of congenital hydrocephalus is due to stenosis of the aqueductus sylvii, which inhibits the flow rate of cerebral fluid. This is often associated with the effects of deficiency/low levels of folic acid consumed by the mother during pregnancy, resulting in failure of brain development during the fetal period. Research data from several case studies shows that the effect of giving folic acid during pregnancy can reduce the incidence of hydrocephalus in children. Therefore, we can actually prevent hydrocephalus from the moment a husband and wife start planning a pregnancy, by regularly taking folic acid tablets before and during pregnancy.

Symptoms that are often found in children who experience hydrocephalus are growth in head circumference that is not appropriate to the child's age, so that with the naked eye we can see that the size of the head tends not to match the proportions of the child's face. Apart from that, we can also check the condition of the crown of the head which tends to be tense/protruding. There is nausea and vomiting for no reason, seizures without fever, and even in more severe conditions, the child may experience decreased consciousness. This occurs because the effect of increased intracranial pressure is no longer compensated.
Making a diagnosis of hydrocephalus in modern times like today is very easy. Hydrocephalus can even be detected when the fetus is still in the womb by screening using ultrasound (ultrasonography). In babies/children, we can confirm the diagnosis of hydrocephalus through a CT (Computerized Tomography) scan of the head. This examination tends to be simple and quick to determine the anatomical condition and image of the child's brain, so that even in cases of fussy babies we can carry it out and get good results.
Treatment in cases of hydrocephalus should be directly consulted with the nearest neurosurgeon specialist, or if the health facility does not have a neurosurgeon specialist, then you can see a pediatrician, so that the parents of the baby/child can receive clear and accurate information according to a medical perspective. Hydrocephalus cases must be  treated quickly, appropriately and accurately. This is important to save the growth and development of the child's brain. Because conditions resulting from abnormal accumulation of brain fluid will inhibit brain development, resulting in delays.

Currently, several modalities are available for treating hydrocephalus cases. The most popular surgical procedure is to install a bypass tube to drain brain fluid that is "trapped" in the ventricular system into the peritoneal cavity to be absorbed, this operation is known as Ventriculoperitoneal Shunt (VP Shunt). The VP shunt procedure is a simple operation, but has had a positive impact in increasing life expectancy and growth and development in children who experience hydrocephalus. Apart from the VP shunt, currently a minimally invasive surgical method for treating hydrocephalus cases is also being developed, called Endoscopic Third Ventriculostomy (ETV). However, to determine the best surgical option for your child, further consultation with a neurosurgeon specialist is required.
Congenital abnormalities in children, including hydrocephalus, are still common in the community. Let's fight together to provide hope of life for optimal child growth and development.

Friends of Hermina Serpong  can directly consult about these problems & symptoms with a specialist neurosurgeon at Hermina Serpong Hospital or can register online via the Halo Hermina application