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Neurology (Expert Forum)
Adult Onset Hydrocephalus
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Adult Onset Hydrocephalus
by T-Walker, Mar 06, 1999 12:00AM
I'm a 38 year old female who is being tested for MS because of the numbness and tingling on the left side.
The brain, cervical and thoracic MRI didn't show any lesions. However, the brain MRI did show an enlargement
of the lateral and 3rd ventricles, no masses or tumors were seen, there is no evidence of atrophy or widening
of the corticalu sulci. However, there is increased signal surrounding the lateral ventricles on the
proton-density images suggesting very minimal trans-appendable CSF resorption, the 4th ventricle is normal in
size and the cortical sulci is not widened (I'm not sure what all this means). I'm not showing an symptons
of Hydrocephalus and my Neuro said I was probably born with this condition. My Neuro referred me to a
Neurosurgeon, who said I had one of two options. I could wait and see and have either MRI's or CT scans every
six months to see if there are any changes in the enlargement or have a shunt put in place. I chose to wait
and see since I'm not having any symptons.
My question is, since I'm not having any symptons is there any long term harm in waiting and is it possible
the enlagrement is a variant of normal?
Thank you in advance for taking the time to read and answer my question.
Sincerely,
T. Walker
Doctor's Answer
by CCF Neurology MD:NT, Mar 06, 1999 12:00AM
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Dear Ms. Walker:
With the information available, I think that option of "waiting and watching" is the right one. Symptoms of a slowly growing hydrocephalus (as you likely know) are gait difficulties, urinary frequency and incontinence, memory and cognitive changes, headaches, and visual signs and symptoms. Even if they occur, they tend to reverse in the early stages with treatment (i.e. with shunting or a similar procedure). Several individuals have what is termed "arrested hydrocephalus". Their have enlarged ventricles, but these do not grow any further because a balance of flow and pressure has been reached.
It is, however, critically important for your neurosurgeon to have determined what the cause of the hydrocephalus is. Some causes are congenital, such as cysts, aqueductal stenosis, or malformations, while others are new and potentially lifethreatening such as tumors.
As you have mentioned, periodical follow-up MRI scans are usually indicated in your situation.
Good luck!
