• Review should include possible causes and ways to identify the cause, treatments with their side effects, current areas of research, and experts on the disease, especially any experts in the California Bay Area.
• Focus on Hydrocephalus occurring in old age.

Data Availability

Causes

• According to the Mayo Clinic, Hydrocephalus is caused by "an imbalance between how much cerebrospinal fluid is produced and how much is absorbed into the bloodstream."
• This can be caused by either an obstruction that prevents the flow of fluid; poor absorption of the fluid; or overproduction of the fluid.
• There are different types of hydrocephalus depending on the cause of the fluid imbalance. These types include Communicating hydrocephalus, Non-communicating hydrocephalus, Hydrocephalus ex-vacuo, and Normal Pressure Hydrocephalus (NPH).
•  Risk factors include: lesions or tumors in the brain or spinal cord; infections that affect the central nervous system like bacterial meningitis or mumps; brain bleeds such as those caused by injury or stroke; and traumatic injury to the brain.

Treatments

•  Treatments for the condition are mostly surgical. There are two types of surgical treatments:
•  A shunt could be inserted into the brain and run under the skin into the chest cavity or the abdomen so the extra fluid can be absorbed by the body.
• An Endoscopic Third Ventriculostomy (ETV) could be performed. This is where "a tiny hole is made at the bottom of the third ventricle and the CSF is diverted there to relieve pressure. Sometimes this is done in conjunction with choroid plexus cauterization to try and decrease the production of CSF. Choroid plexus cauterization uses electric current to burn the CSF-producing tissue (i.e., the choroid plexus) in the lateral ventricles in the brain, so it produces less CSF."
• A shunt can become clogged, and will generally require multiple surgeries over the course of the patient's lifetime to replace the shunt.

Experts/Major Organizations

• The Hydrocephalus Clinical Research Network (HCRN) is an association of doctors doing research on pediatric hydrocephalus.
• The National Institute of Neurological Disorders and Stroke (NINDS) does research on the brain, stroke, and neurological disorders including hydrocephalus. Researchers supported by NINDS are currently conducting research on two areas surrounding hydrocephalus: gene-mutations that may be associated with the disease and "how hydrocephalus affects brain nerve networks and brain function."
•  Leading doctors for hydrocephalus in California are Dr. Marvin Bergsneider; Dr. Christopher Duma; Dr. Lawrence Dickinson and Dr. Jefferson Chen.

Research Summary