Hydrocephalus can create balance issues for older adults

Published: Saturday, November 7, 2009

Submitted by Dr. Alis Vidinas

While you may not be familiar with hydrocephalus, chances are at some time you’ve heard the phrase “water on the brain.” This used to be what hydrocephalus was known as -- although the “water” was actually cerebrospinal fluid, which surrounds the brain and spinal cord. This fluid is what cushions our brains. But too much of it may result in dangerous pressure on the brain tissues and negatively affect how the brain works.

Some individuals are born with hydrocephalus, others develop it. Normal pressure hydrocephalus is the form that occurs most often among older adults. It can be brought on by any one of a number of factors, such as a head injury, an infection, surgery or a brain hemorrhage. Sometimes, there’s no apparent cause. If a cause can be determined and corrected, however, symptoms may improve.

As the condition progresses, the symptoms become more pronounced. In the early stages there may be changes in how the individual walks and in their ability to walk. Legs may feel weak, and the person may fall without warning.

The National Institute of Neurological Disorders and Stroke lists other possible symptoms of normal pressure hydrocephalus as headache followed by vomiting, nausea, problems with balance, poor coordination, urinary incontinence, lethargy, drowsiness, irritability or other changes in personality or cognition, including memory loss. These symptoms, and others, can vary with age, disease progression and each person’s tolerance for the condition.

Many of these symptoms also occur with other illnesses that affect seniors, such as Alzheimer’s and Parkinson’s diseases. Because of this, normal pressure hydrocephalus may be misdiagnosed. Among the tests that may be used to determine whether an individual has this condition are CT scan, MRI, spinal tap and neuropsychological exams. These tests can also rule other health issues in or out. The determination of which test or tests to use varies between individuals and will depend on a number of factors such as their age, symptoms and physical condition.

There are treatment options for persons with hydrocephalus. The most common one is a shunt, or tube, that’s placed in the brain during surgery. The excess fluid is moved away from the brain and absorbed into the circulatory system. It’s important for the patient to continue to see his or her physician regularly after undergoing this procedure to ensure that no infection has set in and that the shunt is working properly and that no adjustments are needed.

How well a patient recovers can depend on how far the condition has progressed and, of course, how well they respond to the treatment. Some people respond extremely well. As with other conditions and illnesses, early detection and intervention is important to eventual recovery. Left untreated, the symptoms generally worsen and lead to death.

When should an individual seek medical attention? It’s always important to be aware of changes to your overall health. Changes in balance, coordination and memory are among those that should be brought to your health care provider’s attention. They could be a symptom of normal pressure hydrocephalus or an indication there’s another issue that needs to be treated. Abrupt changes in someone’s level of awareness or overall mental state require immediate medical attention, and 911 should be called or the person should be taken to an emergency room.

Alis Vidinas, M.D., is a family practitioner at the Henry Ford Medical Center-Fairlane in Dearborn. For an appointment call (800) HENRYFORD.