Definition - What does Hydrocephalus mean?

Hydrocephalus is a condition that occurs when there is an increase in the volume of cerebrospinal fluid (CSF) in the brain due to an imbalance in production, absorption, and flow of the fluid. The accumulated fluid then exerts pressure on the surrounding brain tissue. Apart from damaging the tissue, the pressure can interfere with physical and mental development

Hydrocephalus can be congenital or acquired (after birth in childhood or adulthood). Infertility can be a complication of the condition, especially in children suffering from pediatric hydrocephalus (PH).

FertilitySmarts explains Hydrocephalus

Congenital hydrocephalus affects 1 in 1000 births. Large head size is an indication of the condition. While congenital and acquired are the two main types of the condition, it can further be classified depending on the flow of fluid:

  • Communicating - fluid flows freely between the ventricle/cavities
  • Non-communicating - obstruction within the ventricles
  • Normal pressure hydrocephalus (NPH) - if obstruction develops over a time, which is more common in people above 60 years old.

Symptoms of the disease include nausea, vomiting, headache, blurry vision, bladder control issues, balance problems, problems with cognition and memory

Infertility is one of the long-term complications of the disease, the chances of which are greater if hydrocephalus occurs in infancy. Factors that contribute to infertility include:

  • Abdominal lesions
  • Scarring due to surgery
  • Hormonal imbalances that also result in disorders related to growth and puberty

For example, NPH is said to be associated with diminished activity of gonads (testes and ovaries) due to dysfunction of a pea-sized but master gland called pituitary gland that regulates the activity of several hormonal glands.

It is the increased intracranial pressure that affects the normal function of the gland at times.

If left untreated, hydrocephalus can be fatal. Management of the condition involves inserting a shunt- a mechanical device that allows excess CSF to be transferred to another absorption site, mostly abdomen. Not only does the shunt regulate CSF in the body, but also just allows flow in one direction.

It is possible to diagnose fetal hydrocephalus in the second trimester of the pregnancy. However, due to the continuous fluctuations in pressure, the brain can become damaged and shunt insertion after birth may not offer much improvement. In selected cases shunt insertion may be considered as a treatment of fetal hydrocephalus.

Shunt insertion can also have complications related to infertility because of widespread scarring and adhesions in the abdomen.

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