What causes hydrocephalus in children?

The so-called hydrocephalus in children refers to the excessive accumulation of fluid in the ventricular system of infants and young children, which will cause increased pressure in the brain. This disease is closely related to age. The symptoms vary with age. Common symptoms include developmental delay, vomiting, headache, irritability, epilepsy, etc. What is the cause of this disease?

1. Causes

1. Excessive production of cerebrospinal fluid: In addition to choroid plexus papilloma in the ventricular system, diffuse villous hyperplasia of the choroid plexus is an extremely rare cause of excessive production of cerebrospinal fluid.

2. Impaired cerebrospinal fluid absorption: In children with intracranial hemorrhage or central nervous system infection, adhesions form in the subarachnoid space at the base of the skull, leading to reduced absorption of cerebrospinal fluid by arachnoid granules. Most cases of hydrocephalus are caused by impaired cerebrospinal fluid absorption.

3. Obstruction of cerebrospinal fluid circulation channels: caused by congenital or acquired factors, obstruction of cerebrospinal fluid circulation channels includes intraventricular obstruction and extraventricular obstruction.

2. Clinical manifestations

The head usually starts to enlarge several weeks after birth, and is usually gradually discovered after 3 to 5 months. Some babies may have an enlarged head at birth. Clinically, the head progressively enlarges abnormally due to increased intracranial pressure, which is disproportionate to the development of the whole body. The forehead protrudes forward, the orbital roof is pressed downward, the two eyes look downward, and the eyeballs turn downward, causing the upper part of the sclera to appear white, the anterior fontanelle to expand and the tension to increase, the other fontanelles may also expand, the skull sutures to separate, and the scalp veins to dilate. Percussion of the head produces a "broken pot sound". When the sutures of infants and young children are not closed and the intracranial pressure increases, the head may undergo compensatory expansion, so the symptoms of increased intracranial pressure may not be obvious in the early stages. However, it may also occur when hydrocephalus is severe and progresses rapidly, with symptoms such as repeated vomiting. Brain degeneration, brain development disorders, central paralysis of the limbs, especially the lower limbs, often with intellectual changes and developmental disorders. The optic nerve may be compressed and atrophied, which may lead to blindness. Nystagmus and convulsions are also common. It is also often complicated by deformities in other parts of the body.

In a few cases, hydrocephalus may stop on its own after developing for a certain period of time. The head no longer continues to grow and the intracranial pressure is not high, which becomes "static hydrocephalus."

3. Inspection

1. The infant's head is abnormally enlarged, the anterior fontanelle is full and bulging, and the infant vomits and cries repeatedly. The percussion of the head makes a "broken pot" sound, and both eyes show a "sunset sign".

2. Ultrasound and X-ray examinations of the head showed that the cranial cavity was enlarged, the skull was thinner, the cranial sutures were widened, and the fontanelle was enlarged.

3. Brain ultrasound examination showed symmetrical enlargement of bilateral ventricles.

4. CT or MRI of the head can show the extent of ventricular enlargement and measure the thickness of the cortex, thereby understanding the location of the blockage and the cause of hydrocephalus.