Hydrocephalus Quote

It's Not What Happens That Counts, but How We Handle It

Water on the Brain in Cats

 

Hydrocephalus in Cats

Hydrocephalus is the abnormal dilation, or expansion, of the ventricular system due to an increased volume of spinal fluid. In this case, the ventricles that are connected with the spinal cord are the ventricles that are being affected. The abnormal dilation may affect only one side of the brain, or both sides. It may involve the entire ventricular system (a set of hollow structures in the brain continuous with the central canal of the spinal cord), or only elements next to a site of ventricular system obstruction.

There are two types of hydrocephalus – compensatory and obstructive. Both compensatory and obstructive hydrocephalus can be congenital (present at birth) or acquired. With compensatory hydrocephalus, spinal fluid fills the space where the nervous system’s functional parts have been destroyed and/or failed to develop. Intracranial (within the brain) pressure is a normal result. This is ventricular dilation incidental to the primary disease.

In the case of obstructive hydrocephalus, spinal fluid accumulates due to an obstruction along the normal circulatory pattern (noncommunicating hydrocephalus), or the fluid accumulates at the fluid resorption site near the meningeal arachnoid villi (communicating hydrocephalus). The meninges are composed of three membranous envelopes – the pia mater, which lies against the brain; the arachnoid, the middle layer; and the dura mater, the outer, thicker layer closest tot he skull – that surround the brain and spinal cord. Intracranial (within the skull) pressure may be high or normal. However, clinical signs may be noted when intracranial pressure is normal.

Congenital obstruction causes primary obstructive hydrocephalus. The most common site of obstruction is at the level of the mesencephalic (middle brain) aqueduct. Prenatal (before birth) infections may cause aqueductal stenosis (narrowing) with subsequent hydrocephalus. This may result in considerable disruption of the architecture of the brain.

Acquired obstruction results in secondary obstructive hydrocephalus. It is caused by tumors, abscesses, and inflammatory diseases (including inflammation resulting from hemorrhage that has been caused by traumatic injuries or other causes of bleeding). The sites of obstruction include the interventricular foramina (channels that connect the paired lateral ventricles with the third ventricle at the midline of the brain), the mesencephalic aqueduct, or the lateral apertures of the fourth ventricle.

Overproduction of spinal fluid can also cause hydrocephalus. However, this is rare. It may also be caused by a tumor in the eye.

The congenital form is an inherited disease in Siamese cats. Acquired hydrocephalus can occur in all breeds. Congenital hydrocephalus usually becomes apparent within a few week of birth, and up to a year of age. Acute onset of signs can occur with previously undiagnosed congenital hydrocephalus. The exact cause of this uncertain. Acquired hydrocephalus can occur at any age.

Symptoms and Types 

May be without symptoms

Wetting or soiling in the house

Sleepiness

Excess vocalization

Hyperexcitability

Blindness

Seizures

A large dome-shaped head (due to intracranial swelling)

Crossed-eyes

Gait abnormalities

Coma

Abnormal breathing

Animal may arch its head back and extend all four legs

Causes

Congenital

Genetics

Prenatal infection

Coronavirus

Exposure to teratogens (drugs that interfere with fetal development) in utero

Brain hemorrhage in newborn after a difficult labor

Vitamin A deficiency

Acquired

Intracranial inflammatory diseases

Masses in the cranium

Diagnosis

You will need to provide your veterinarian with a thorough and detailed history of your cat's health, including any information you have about its birth and parentage, the onset of symptoms, and any possible incidents, including minor falls, that might have preceded this condition. Your veterinarian will perform a complete physical exam on your cat, with a complete blood profile, chemical blood profile, complete blood count, an electrolyte panel, and a urinalysis, in order to effectively rule out or confirm evidence of trauma, infection, or cancer.

Diagnostic imaging is essential. Skull radiographs may help to diagnose congenital hydrocephalus, but computed tomography (CT) and magnetic resonance imaging (MRI) are best for visualization, enabling your veterinarian to come to a definitive diagnosis.

Other diagnostic tests that can assist in the diagnosis of hydrocephalus are a spinal tap, with a laboratory analysis of the fluid, and an electroencephalogram (EEG) for measuring the brain’s electrical activity.

Treatment

Your cat will require hospitalization if it is exhibiting severe signs or requires surgery. Those with less severe symptoms may be treated medically on an outpatient basis. Hospitalized patients need to be turned regularly to prevent pressure sores, provided with eye lubricant to protect the eyes from drying out, and properly positioned to prevent aspiration pneumonia.

 

Living and Management

Your veterinarian will schedule follow-up appointments with you depending on the severity of your cat's condition after hospitalization. How well your cat recovers will depend on the cause and severity of the illness. If your cat has a mild congenital form of hydrocephalus, there is a good prognosis and it may require only occasional medical treatment to keep it under control. 

Here is the link that I got the information from: https://www.petmd.com/cat/conditions/neurological/c_ct_hydrocephalus

Educational Hydrocephalus Post

 

Overview

Hydrocephalus is the buildup of fluid in the cavities (ventricles) deep within the brain. The excess fluid increases the size of the ventricles and puts pressure on the brain.

Cerebrospinal fluid normally flows through the ventricles and bathes the brain and spinal column. But the pressure of too much cerebrospinal fluid associated with hydrocephalus can damage brain tissues and cause a range of brain function problems.

Hydrocephalus can happen at any age, but it occurs more frequently among infants and adults 60 and over. Surgical treatment for hydrocephalus can restore and maintain normal cerebrospinal fluid levels in the brain. Different therapies are often required to manage symptoms or problems resulting from hydrocephalus.

Symptoms

The signs and symptoms of hydrocephalus vary somewhat by age of onset.

Infants

Common signs and symptoms of hydrocephalus in infants include:

Changes in the head

• An unusually large head
• A rapid increase in the size of the head
• A bulging or tense soft spot (fontanel) on the top of the head

Physical signs and symptoms

• Nausea and vomiting
• Sleepiness or sluggishness (lethargy)
• Irritability
• Poor eating
• Seizures
• Eyes fixed downward (sunsetting of the eyes)
• Problems with muscle tone and strength

Toddlers and older children

Among toddlers and older children, signs and symptoms might include:

Physical signs and symptoms

• Headache
• Blurred or double vision
• Abnormal eye movements
• Abnormal enlargement of a toddler's head
• Sleepiness or sluggishness
• Nausea or vomiting
• Unstable balance
• Poor coordination
• Poor appetite
• Loss of bladder control or frequent urination

Behavioral and cognitive changes

• Irritability
• Change in personality
• Decline in school performance
• Delays or problems with previously acquired skills, such as walking or talking

Young and middle-aged adults

Common signs and symptoms in this age group include:

• Headache
• Sluggishness
• Loss of coordination or balance
• Loss of bladder control or a frequent urge to urinate
• Vision problems
• Decline in memory, concentration and other thinking skills that may affect job performance

Older adults

Among adults 60 years of age and older, the more common signs and symptoms of hydrocephalus are:

• Loss of bladder control or a frequent urge to urinate
• Memory loss
• Progressive loss of other thinking or reasoning skills
• Difficulty walking, often described as a shuffling gait or the feeling of the feet being stuck
• Poor coordination or balance

When to see a doctor

Seek emergency medical care for infants and toddlers with these signs and symptoms:

• A high-pitched cry
• Problems with sucking or feeding
• Unexplained, recurrent vomiting
• Seizures

Seek prompt medical attention for other signs or symptoms in any age group.

More than one condition can cause the problems associated with hydrocephalus, so it's important to get a timely diagnosis and appropriate care.

Causes

Hydrocephalus is caused by an imbalance between how much cerebrospinal fluid is produced and how much is absorbed into the bloodstream.

Cerebrospinal fluid is produced by tissues lining the ventricles of the brain. It flows through the ventricles by way of interconnecting channels. The fluid eventually flows into spaces around the brain and spinal column. It's absorbed primarily by blood vessels in tissues on the surface of the brain.

Cerebrospinal fluid plays an important role in brain function by:

• Keeping the brain buoyant, allowing the relatively heavy brain to float within the skull
• Cushioning the brain to prevent injury
• Removing waste products of the brain's metabolism
• Flowing back and forth between the brain cavity and spinal column to maintain a constant pressure within the brain — compensating for changes in blood pressure in the brain

Too much cerebrospinal fluid in the ventricles occurs for one of the following reasons:

• Obstruction. The most common problem is a partial blockage of the flow of cerebrospinal fluid, either from one ventricle to another or from the ventricles to other spaces around the brain.
• Poor absorption. Less common is a problem with absorbing cerebrospinal fluid. This is often related to inflammation of brain tissues from disease or injury.
• Overproduction. Rarely, cerebrospinal fluid is created more quickly than it can be absorbed.

Risk factors

In many cases, the cause of hydrocephalus is unknown. However, a number of developmental or medical problems can contribute to or trigger hydrocephalus.

Newborns

Hydrocephalus present at birth (congenital) or shortly after birth can occur because of any of the following:

• Abnormal development of the central nervous system that can obstruct the flow of cerebrospinal fluid
• Bleeding within the ventricles, a possible complication of premature birth
• Infection in the uterus — such as rubella or syphilis — during pregnancy, which can cause inflammation in fetal brain tissues

Other contributing factors

Other factors that can contribute to hydrocephalus among any age group include:

• Lesions or tumors of the brain or spinal cord
• Central nervous system infections, such as bacterial meningitis or mumps
• Bleeding in the brain from a stroke or head injury
• Other traumatic injury to the brain

Complications

In most cases, hydrocephalus progresses, which means complications, including intellectual, developmental and physical disabilities, can occur if it's not treated. It can also be life-threatening. Less severe cases, when treated appropriately, might have few, if any, serious complications.

Hydrocephalus Definition

A build-up of fluid in the cavities deep within the brain.

The extra fluid puts pressure on the brain and can cause brain damage. It's most common in infants and older adults.

Hydrocephalus is characterized by head enlargement in infants. Adults and older children experience headache, impaired vision, cognitive difficulties, loss of coordination, and incontinence.

Treatment is often a tube (shunt) inserted surgically into a ventricle to drain excess fluid.

Here is a definition of what people like myself have. I hope this helps you learn a little bit about what it is.

Hydrocephalus Interview Diary #2

This past week I messaged some questions to Clio Lang who I became friends with just by doing a zoom call with others like myself, who have Hydrocephalus. I reached out to her on one of the lives she was doing on her social media and asked her if she would like to be interviewed for my blog, so that I could help share her story. She said yes, and so I sent her some questions, and now here is Her Story for all of you to read. I hope that as you read Her Story that you will be inspired by it, just like I have been.

Q. When were you first diagnosed with Hydrocephalus?

A. I was diagnosed with Hydrocephalus in infancy.

Q. How did people, like family or your doctors help you to learn and understand about what you had?

A. I didn't understand what I had and how it could actually affect my entire life if my shunt failed until I was 23. 

Q. Is there ever or has there been a time that you felt like you didn't belong or fit in because of what you went through? If so, what is something that you wished people knew now, that they didn't know before?

A. I always felt like I didn't fit in, because I was bullied in grade school but eventually was admitted in regular classes in junior high. People need to understand that having a shunt is a barrier. You can't see it but it's there and it HURTS. 

Q. What are some things you dealt with in school, that you had trouble with?

A. In school, I had trouble with comprehension and math. Omg I hated math.

Q. Would you say that you had trouble with making friends?

A. Being introverted since childhood made me shy but eventually I would make close friendships with people.

Q. How have you overcome different things that you may have struggled with growing up and how do you face those struggles that may have been difficult for you growing up to now?

A. I've overcome codependency because having a shunt and multiple brain surgeries forced me to advocate for myself. My biological parents didn't want me or my sister so were were adopted. It was very difficult.

Q. Do you ever feel like you couldn't always share what you went through growing up with your peers because they didn't understand?

A. Nobody understood what a shunt or hydro was. If I even spoke about it with previous romantic relationships; I'd get this confused look as if I spoke another language. So I stopped talking about it.

Q. Is there a time when you wished you knew someone who could relate to what you went through and could share the same experiences?

A. I found the Hydrocephalus Association in 2017; before then, I knew no one else with hydro.

Q, How has being able to know there are others who have Hydrocephalus and how has it helped you be able to share your story with others?

A. Now, I've built close relations with other hydro warriors! It has shaped me into being an activist now to spread awareness on Hydrocephalus.

Q. What do you hope people learn from when they read your story?

A. People should learn that hydro is more common than Down Syndrome and is the leading cause of brain surgery in children.

Q. Finally, is there one thing that you wish people knew more about you and what you went through growing up, and now that they didn't know before?

A. Some people have enlarged heads; not everyone looks the same but we do suffer and are constantly overshadowed by other invisible illnesses. Hydrocephalus is actually an ancient condition that should have widespread knowledge.

Hydrocephalus Interview Diary #1

 This interview is about a friend of mine named Ian McDonough  This, is His Story. I asked him questions and he gave me some answers and some may have been difficult because of things he may not have known because it may not have been shared with him but a lot of us have those moments where we may not know when someone asks a question we don't have an answer for. With that being said, let's start.

Q, When did you first get diagnosed with Hydrocephalus?

A. I was diagnosed at 3 months old.

Q, Where there any concerns after you were diagnosed and were you born with it?

A. Well, my parents main concern were the physical and mental limitations that they were told I'd have. They were told I would be mentally handicapped and in a wheelchair.

Q. How long were you in the hospital for and did they have to monitor in case there were any signs of seizures or any health concerns?

For this question of their answer they were unsure as they didn't really know. I told them that was okay because for that type of question, I probably have the same feeling of being uncertain if someone asked me.

Growing up did the doctors ever think you would talk?

For the answer to this question they gave me, they mentioned how it wasn't specified to them growing up, and how it could have fallen under the category of mentally handicapped. 

What were some of the challenges during school, for you that you faced growing up and have you felt like you overcome some of those challenges growing up?

Walking was very awkward for me growing up. I wore an ankle brace until I believe 4th grade. Up until 6th grade I'd get pulled out of class for an hour to do physical therapy to try and get my walking under control. Mentally things were never really a problem till 10th/11th grade where I suddenly lost my ability to focus. If it wasn't for recent [non hydrocephalus] complications, my walking was fine, and I was even a runner for a while before it happened. 

During your grade school years or high school years did you ever feel like kids picked on you because of what you went through or did you have a group kids that understood? 

Meaning, did you have friends that understood, and supported you, so that you wouldn't get picked on?

Not specifically. I can't say that anyone in particular stood up for me. However my memories before 5th grade or so may be a little fuzzy, but I think the bullying related to my hydrocephalus issues didn't really happen until high school. I had friends, but I can't really say that anyone stood up for me in those instances.

When you graduated did college  for you get easier or was it a little bit difficult and did you ever need more time or help?

I'd say that if went in either direction it got more difficult. I talked to the department in my college that dealt with accommodations for people with disabilities because I needed two things. Extended time and an alternate test site. I never knew exactly why being around a lot of other people made it hard for me to focus, but that seemed to be what happened.

The extended time was kind of a back-up in case the alternate test site didn't take all the anxiety away, and I needed to use it more often than not. 

How would you describe your experiences growing up and what you're going through now? Would you say some or all of what you went through growing up is different to what you are experiencing now  or would it be different?

Once I hit my teenage years, hydrocephalus didn't even feel like a concern for me. I only had one shunt issue, that being total failure of my VP shunt when I was 13. I'm not entirely sure how, but the neurosurgeon in the ER determined it was failing, and shortly after brought me to the O.R., he checked it again and it was working fine. Now it's more of a concern because I've had two revisions and an LP shunt placement inside of 2 years after going 24 years without a problem. So now there's all that lingering thought of will it happen again? I'd say it's totally different, because for 24 years I didn't have to think about it. Now being older and having gone through a couple difficult complications, I've come to understand that shunt malfunctions can happen at any time.

What would you say has been the best part for you when you found out that there was a group for people like you and did you ever think you would meet others going through the same things you did?

I think the best thing about it is having a group of people who understand what I am going through. My parents understand, but they've never actually lived it. Finding people who have been dealing with hydrocephalus as long as I have [some a shorter amount of time, but the point is the same] makes me feel like I can actually talk about my experiences with people who know how it feels. I honestly never thought I'd find a group like that.

I then asked permission if I could share his name with this and he said of course.