does anyone out there know anything about adult onset hydrophepelas and long standing aqueductal stenosis?

Question

i had surgery for this condition 5 years ago .they did a third vetrlectomy on me that was suppose to clear it up but a recent mri and various symptoms show that its back. whats the next step?a shunt? my neorelogist doesn'know. someone please help me. i'm a 43 year old female.

Answer 1

Causes of hydrocephalus.
There are a number of causes of hydrocephalus, these are either developmental or genetic. Genes are not passed from generation to generation unchanged. Genes go through a process called meiosis when they divide to form gametes, this process mixes the genetic material between the genes. Genes can also be changed by external forces, some substances can cause alterations of the genes, as can radiation. These genetic changes can lead to developmental changes, which were not passed from their parrents. Most cases of genetically caused hydrocephalus lead to several malformations, one, or more, of these will affect the nervous system.

Blockage of CSF can be caused by a variety of conditions( spina bifida and other birth defects of the brain, certain brain infections (like meningitis, pus can cause a blockage), hemorrhage within or around the brain, usualy due to prematurity or a ruptured aneurysm, brain trauma, or tumors). The blockage can be within the ventricles themselves (obstructive hydrocephalus) or outside the brain in the areas where the spinal fluid is reabsorbed back into the blood stream (communicating hydrocephalus).

In babies which are born with hydrocephalus, without there being genetic causes, the condition is said to be congenital. In congenital hydrocephalus the actual cause is usually impossible to determine, these cases are said to be idiopathic, it is assumed to be due to events during the baby's development before birth, such as damage to local blood supply or infection.

Aqueductal stenosis
Aqueductal stenosis is the enlargement of the lateral and 3rd ventricles with a normal 4th ventricle. The aqueduct can be atretic(with-out natural openings) and subdivided into several small forked channels. A web or membrane composed of ependymal cells can run across the aqueduct. A third variety consists of two blind-ended channels with no true lumen. Rarely aqueductal stenosis can be familial with an X-linked recessive form of inheritance. The mumps virus can be associated with aqueductal stenosis.
The cerebral aqueduct can become secondarily stenotic (narrowed) in shunted hydrocephalus due to other causes, usually with obstruction of the 4th ventricle outflow pathways as the etiology(cause) of the hydrocephalus. This produces a situation where the 4th ventricle becomes trapped due to blockage of its outflow and inability of fluid to flow upward into the shunt. If symptomatic, the encysted, trapped 4th ventricle needs a second ventricular catheter which is connected into the existing shunt above the valve to ensure equal flow in both compartments.
The MRI scan is an excellent study to visualize the cerebral aqueduct and diagnose the stenosis. It will also differentiate aqueductal stenosis from a periaqueductal glioma(a malignant growth of nerve connective tissue), an indolent midbrain tectal tumor which is usually not seen on CT scanning. Aqueductal stenosis is seen in association with Chiari malformations either due to stenosis or narrowing due to the angulation and distortion of the brainstem with the Chiari malformation. The posterior fossa is small in hydrocephalus due to aqueductal stenosis.
Hydrocephalus due to aqueductal stenosis usually becomes manifest in-utero or by the first three months of infancy with typical signs of elevated intracranial pressure, bulging anterior fontanelle, splitting of the sutures, characteristic sound to head percussion and "setting-sun sign" due to tectal compression. Teenagers and young adults can present for the first time with aqueductal stenosis and hydrocephalus. This older group of patients usually presents with chronic headaches in the setting of having head which is large on the growth chart, and there may be history of school problems and learning disabilities throughout the learning years of childhood. Appropriate imaging studies diagnose the problem, and if symptomatic a VP shunt is recommended. Hydrocephalus in-utero is frequently noted by ultrasound studies during pregnancy. Aqueductal stenosis is the cause of hydrocephalus in about 40% of cases. Hydrocephalus due to aqueduct stenosis usually occurs in-utero or within 3 months after birth.

Answer 2

My father has normal pressure hydrocephalus. My advice is to get seen at a major medical center by a neurologist who treats hydrocephalus as his special area of interest. If after being examined by this hydrocephalus expert you are told that you need a shunt then get the surgery done as soon as possible - again by a surgeon who does this specific surgery regularly. My father waited too long for surgery and now he has Parkinson's symptoms and dementia despite having had the shunt surgery.

http://www.emedicine.com/NEURO/topic161.htm

http://www.emedicine.com/NEURO/topic277.htm

good luck

Answer 3

Not really. Did ya find ANY thing on the 'puter or Internet/ 'net?!? I had hydrocephalus as a baby, when I was born. I also have trouble NOW with FLUID BUILD- UP in my MID- EAR/ INNER EAR, WHICH MAY (ALSO) BE A 'SYMPTOM' of HYDROCEPHALUS! I AM going for an M.R.I. AGAIN, though I HAD ONE APPROX. 7 YEARS AGO! The FIRST one showed FLUID 'BLOCKAGE' IN 3 DIFFERENT places, 'cuz the BRAIN DOES NOT LIKE 'EMPTY' SPACE!!! They talked about a SHUNT, BUT NEVER DID PUT ONE IN! I think it is/ was 'cuz, since the brain is AS FULLY DEVELOPED AS CAN BE IN AN ADULT, IT PROBABLY WILL NOT HELP! I DUNNO... :( AND :((

Answer 4

I agree with the above analysis.