Hydrocephalus

Hydrocephalus, or water on the brain, some are born with it, some have acquired it.

normal-hydrocephalus-comparison

In ancient greek, “hydro” meaning water ” kephalos” meaning head….

While you and I will always pronounce the “cephalus” as sefalus, doctors generally use the ancient greek word, and pronounce it with the “k”, like in kettle……boring fact maybe……but it’s not surprising we struggle to understand doctors sometimes, they’re not even speaking our language!!

Jennifer acquired hers due to blood blocking the normal pathway for the drainage of cerebrospinal fluid out of the ventricles.

Cerebrospinal fluid or CSF, is the fluid that protects our brain.

We produce cerebrospinal fluid in the amount of  500ml/day. Our brain weighs around 1400grams, but its net weight in the CSF is equivalent to the mass of around 25 grams. Our brains therefore are neutrally buoyant. If our brains weren’t floating in CSF they would collapse upon themselves due to their mass.

CSF  protects our brains from sudden injuries, a car accident or a sporting injury, but it can’t protect it from forced contact with the skull.

Walked these hallways a few times!
Walked these hallways a few times!

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Hydrocephalus can appear gradually with little or no symptoms, it can be a minor congenital problem or an infection, it doesn’t necessarily cause brain damage.

But in Jennifer’s case, her’s was an acquired obstructive Hydrocephalus caused by blockage to cerebral aqueduct within the fourth ventricle.

The CSF stopped there, but it didn’t stop producing itself.  As a result the pressure grew rapidly, the ventricles dilated and the nervous tissue was compressed.

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Compression of the nervous tissue resulted in irreversible brain damage…….

When we first saw the pictures of her ventricles we were astounded, it looked like she had 2 huge holes in her brain. But MRI pictures and ultrasound pictures can be misinterpreted if you see them from the wrong angle.

An MRI takes a series of pictures, that see through the body, a series may consist of 50 or so pictures, and you can zoom in through those pictures seeing right into the middle of the person and come out the other side.

See below, it would seem her ventricles are massive, but here you’re looking through the top of her skull, as if you were standing over her, you can also see her shunt.

Here you can see the layers we can scroll through
Here you can see the layers we can scroll through.

You need the exact right angle to measure the ventricles properly, and I have no idea what that angle is……

From memory I think her ventricles measured 4 maybe 5 cm wide.

Now, 18 months after her operation, I think they look almost normal.

MRI Mai 13               ventricles_of_the_brain1352510262050

The circle is where the brain is damaged, it’s clearer than it’s ever been.

Compressed brain tissue, it’s no wonder she can’t see…….that area of the brain is the visual cortex, where our brain interprets what our eyes see.

A little higher towards the top of our heads comes the area that controls our motor skills, also damaged!

I’m no expert at interpreting these pictures, but the rest seems healthy. But to fully interpret you need to study every layer.

We know there is damage inside the 3rd ventricle as well,periventricular leukomalacia, so it will always be bigger than normal, but here it looks ok.

Cerebral aqueduct still looks tight though (the arrow)

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Ready to go in....
Ready to go in….

You may wonder why I put pictures of my daughters brain on the internet……?

It’s more important to us that people understand why Jennifer is who she is, and how brain damage or other problems effect these children.

If you can really understand that, and see past the exterior of the child who is different you’ll have gone a long way in being able understand just how special they really are!!

Recovery
Recovery
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