Is supratentorial ventricular hydrops serious?

Speaking of supratentorial hydrocephalus, most people probably don't know much about it. In fact, this disease is a relatively common hydrocephalus phenomenon. Especially in newborn babies, the probability of supratentorial hydrocephalus is very high, and parents should pay attention to the supratentorial hydrocephalus in their children. So from the perspective of modern medicine, is supratentorial hydrocephalus a more serious brain disease?

1. What to do if your child has hydrocephalus

Compared with adults, the clinical manifestations of hydrocephalus in children vary according to the patient's age of onset. In infants with acute hydrocephalus, there are usually obvious symptoms of intracranial hypertension, such as suture dehiscence, full anterior fontanelle, thinning of the scalp, and clearly visible and dilated scalp veins. When strong light is shone on the head, the skull becomes translucent.

The treatment of hydrocephalus can be divided into conservative treatment and surgical treatment. Conservative treatment requires keeping the head elevated, limiting water intake, and taking diuretics, but the effect is not obvious. There are many surgical treatment methods. The most commonly used one in China is the ventriculoperitoneal shunt, which is a procedure in which one end of a silicone tube is placed into the lateral ventricle and the other end into the abdominal cavity. The tube is buried under the skin and connected to an anti-reflux pump, allowing the high-pressure cerebrospinal fluid in the cranial cavity to flow into the abdominal cavity. Reabsorption relies on the absorption function of the peritoneum to relieve intraventricular pressure and allow brain cells to grow and develop. The development of brain tissue continues rapidly after birth. The brain tissue weighs 350g at birth, 900g at 1 year old, and the weight growth slows down after 1 year old, reaching the adult brain weight of 1.5kg. Therefore, when hydrocephalus is found in children, surgery should be performed as soon as possible. Some patients are expected to return to normal levels of motor and intellectual ability after surgery.

2. Causes of hydrocephalus in children

2.1 Congenital developmental abnormalities

2.1.1. Cerebral aqueduct stenosis, gliosis and septum formation: All of the above lesions can lead to infarction of the cerebral aqueduct, which is the most common cause of congenital hydrocephalus. It is usually sporadic. Sex-linked hereditary aqueduct stenosis accounts for only 2% of all congenital hydrocephalus.

2.1.2 Arnold-Chiari malformation: due to the herniation of cerebellar tonsils, medulla oblongata and fourth ventricle into the spinal canal, the circulation of cerebrospinal fluid is blocked, causing hydrocephalus, often complicated by spina bifida and meningocele.

2.1.3. Dandy-Walker malformation: hydrocephalus caused by congenital occlusion of the middle and lateral holes of the fourth ventricle.

2.1.4. Flat skull base: often combined with Arnold-Chiari malformation, blocking the outlet of the fourth ventricle or the ambient cistern, causing hydrocephalus.

2.2. Non-developmental causes In congenital hydrocephalus, congenital developmental abnormalities account for about 2/5, while non-developmental causes account for 3/5.

3. Symptoms of hydrocephalus in children

3.1. The main feature is the progressive increase in head circumference, which is disproportionate to the development of the whole body and is usually discovered gradually at 3-5 months.

3.2. As the head circumference increases, the face becomes relatively small, the forehead protrudes forward, the head becomes round, the scalp becomes tight and thin, the eyeballs move or squint or tremble, the fontanelles (including the anterior and posterior fontanelles) open, and the skull sutures separate.

3.3. The sick infant is listless and cannot lift his head. In severe cases, there may be brain dysfunction, manifested as epilepsy, visual and olfactory disorders, nystagmus, strabismus, limb paralysis and intellectual disability.

3.4. Due to the compensatory enlargement of the baby's head, the sick baby may have frequent vomiting, irritability and poor eating.

3.5. The sick infants may also suffer from brain degeneration, central paralysis of the limbs, blindness due to compression and atrophy of the optic nerve, intellectual changes and developmental disorders, and are often complicated by deformities in other parts of the body.