Hydrocephalus is a medical condition where a person has a buildup of fluid in the brain.
It’s potentially dangerous when it’s not promptly diagnosed and treated because the skull only has so much room. Anything that occupies that precious space, including fluid, causes an increase in intracranial pressure and the brain itself to shift positions. In the worst cases, the brain is squeezed down through the back of the skull in a deadly situation called brain herniation.
The culprit behind all of this is a specialized fluid that the body produces for the brain and spinal cord. It’s called cerebrospinal fluid (CSF). There are generally two causes of hydrocephalus:
• The blood isn’t absorbing CSF
• There’s some sort of blockage that prevents the proper flow of CSF within the brain
Hydrocephalus can show up at any time. In congenital hydrocephalus, babies are born with the condition. When someone develops the illness as a child or adult, it’s called acquired hydrocephalus.
Anything causing an increase in intracranial pressure is alarming and the standard of care requires nurses and doctors to jump into action. It’s important to get the patient immediate attention from a physician to figure out what’s causing signs and symptoms like:
• A headache that won’t go away
• Nausea and vomiting
• Eyes pointed in a downward position
• Visual disturbances
• Difficulty thinking clearly
• Problems with coordination
• In babies, irritability and enlarged head
When a doctor suspects hydrocephalus or increased intracranial pressure, the standard of care requires ordering an MRI scan of the head and neck. This will allow doctors to see if there are any signs of an obstruction that could be causing a buildup of cerebrospinal fluid in the brain.
Once diagnosed, a neurosurgeon needs to be consulted to make appropriate orders and decisions for management. In most cases, the best solution is taking the person to surgery to place a ventricular drain, which will get rid of the excess CSF.
If the patient is unstable, it’s an emergency surgery. Otherwise, it may be appropriate to schedule the surgery for the next day, with careful observation in an intensive care unit (ICU). In the meantime, some patients need treatment to lower and control intracranial pressure. Standard treatments include:
• Mannitol, a drug that lowers swelling and intracranial pressure
• Hyperventilating the patient, which lowers blood carbon dioxide levels and reduces the blood supply to the brain and, thus, lowers intracranial pressure
One of the risks to patients who aren’t taken to surgery immediately for drain placement is that the ICU doctors and nurses will drop the ball if the patient takes a clinical turn for the worse.
For example, I’m working on a Texas case now involving a child who had acquired hydrocephalus. An MRI showed a blockage, but the patient seemed stable enough to wait until the next day for the ventricular drain placement surgery.
The patient deteriorated overnight in the pediatric ICU, having several episodes of what the doctors and nurses thought were seizures. They fumbled around but waited hours before actually speaking with a neurosurgery attending physician. By then, it was too late. The patient’s brain had herniated. The patient never again regained consciousness.
It’s a tragic outcome that was entirely avoidable!
If you or a loved one has been seriously injured because of mismanagement of hydrocephalus or increased intracranial pressure, then contact a top-rated experienced Houston, Texas medical lawyer for help in evaluating your potential case.