HYDROCEPHALUS

Hydrocephalus, also called Water on the Brain is a condition in which there is an abnormal build-up of CSF
(cerebrospinal fluid) in the cavities (ventricles) of the brain. The buildup is often caused by an obstruction
which prevents proper fluid drainage. The fluid buildup can raise intracranial pressure inside the skull which
compresses surrounding brain tissue, possibly causing progressive enlargement of the head, convulsions, and
brain damage. Hydrocephalus can be fatal if left untreated. The damage to the brain can cause headaches,
vomiting, blurred vision, cognitive problems, and walking difficulties.
The term water on the brain is incorrect, because the brain is surrounded by CSF (cerebrospinal fluid), and
not water. CSF has three vital functions:

It protects the nervous system (brain and spinal cord) from damage
It removes waste from the brain
It nourishes the brain with essential hormones.

The brain produces about 1 pint of CSF each day. The old CSF is absorbed into blood vessels. If the process of
replenishment and release of old CSF is disturbed, CSF levels can accumulate, causing hydrocephalus.
Types of Hydrocephalus
1. Congenital hydrocephalus. This is present at birth. According to the National Health Service (UK),
approximately 1 in every 1,000 babies are born with congenital hydrocephalus, while The Mayo Clinic,
USA, says 1 in every 500 US babies are born with it. It may be caused by an infection in the mother
during pregnancy, such as rubella or mumps, or a birth defect, such as spina bifida. It is one of the most
common developmental disabilities, more common than Down syndrome or deafness.
2. Acquired hydrocephalus. This develops after birth, usually after a stroke, brain tumor or as a result of a
serious head injury.
3. Normal pressure hydrocephalus. This only affects people aged 50 years or more. It may develop after
stroke or injury. In most cases doctors do not know why it occurred.

ANATOMY AND PHYSIOLOGY

THE BRAIN
Our brain is well protected by:
The scalp
The skull
The meninges
Layers includes:
- dura mater (strongest layer, the spaces within the fold of dura mater is called dural venous
sinuses, which collect blood from the small veins of the brain. The dura mater is surrounded by
an epidural space between the dura mater and the periostum of the vertebrae.)

arachnoid mater (very thin layer on the middle of the meninges, the spaces between the dura
mater and arachnoid mater is the subdural mater, which is normally only a potential space
containing a very small amount of serous fluid.)
pia mater (very tightly bound to the surface of the brain and spinal cord, the spaces between the
arachnoid mater and pia mater is the subarachnoid space, which is filled with cerebrospinal
fluid and containing blood vessels.)

VENTRICLES
The CNS contains fluid-filled cavities, called ventricles, that maybe quite small in some areas and large
in others.
- Lateral ventricle each cerebral hemisphere contains a relatively large cavity.
- Third ventricle a smaller midline cavity located in the center of the diancephalon between two
halves of the thalamus and connected to the foramina to the lateral ventricles.
- Fourth ventricle is located at the base of the cerebellum and is connected to the third ventricle
by a narrow canal, called the cerebral aqueduct. It is continuous with the central canal of the
spinal cord.
CEREBROSPINAL FLUID
CSF bathes the brain and spinal cord, providing a protective cushion around the CNS. It is produced by
the choroid plexuses, specialized structures made of ependymal cells, which are located in the ventricles.
FLOW OF CSF:
1. The CSF flows from the lateral ventricles into the third ventricle and then through the cerebral aqueduct
into the fourth ventricle.
2. A small amount of CSF enters the central canal of the spinal cord.
3. CSF flows through the subarrachnoid space to the arachnoid granulations (masses of arachnoid
tissues, penetrate into the superior sagittal sinus, a dural venous sinus in the longitudinal fissure) in the
superior sagittal sinus, where it enters the venous circulation.

FLOW OF CSF IN THE BRAIN: