Hydrocephalus
Hydrocephalus must be diagnosed and treated without delay, or the patient risks developing life-changing brain injuries. The same is true if a shunt becomes blocked.
If medical practitioners fail to diagnose and treated hydrocephalus or a blocked shunt, there could be a case of medical negligence. Please contact us to find out more.
What is hydrocephalus?
Hydrocephalus is the build-up of fluid on the brain. It is sometimes described as 'water on the brain', although in fact it is not a build-up of water but cerebrospinal fluid (CSF).
CSF flows around the brain and the spinal cord, protecting them from harm, providing nutrients and removing waste products. The brain produces about one pint of CSF per day. Any CSF that is not needed passes through a one-way valve and is then absorbed by the bloodstream. This process ensures that excess fluid is drained off.
But hydrocephalus will arise if something upsets this process, causing CSF to build-up on the brain. Exactly why this happens is not fully understood, but medical practitioners have established three different types of hydrocephalus, and there are a number of potential causes for each.
Types of hydrocephalus and their potential causes
The three types of hydrocephalus are:
- 1. Congenital hydrocephalus – when a baby is born with the condition. The cause is not always known, but potential reasons include spina bifida, genetic mutation, genetic disorders, cysts or bleeding on the brain (more common in premature babies.)
- 2. Acquired hydrocephalus – when a child or adult develops hydrocephalus as a result of an illness or injury, such as stroke, meningitis, head injuries, stroke and blood clots.
- 3. Normal pressure hydrocephalus – where an elderly person develops the condition. Again, it is not really known why this happens, but it could be due to underlying health conditions (like diabetes, heart disease and high cholesterol), or due to the tissue not filtering the CSF back into the blood vessels (which could happen after an infection or injury).
Hydrocephalus symptoms and diagnosis
Whatever is causing hydrocephalus, the outcome will be the same: the pressure caused by the build-up of fluid will damage the brain, resulting in a range of symptoms. These vary depending upon the age of the patient, but for an adult will generally include:
- Headache
- Being sick
- Difficulty walking
- Blurred vision
- Difficulty controlling the passage of urine and faeces
- Confusion and drowsiness
The symptoms should lead medical practitioners to suspect a problem with the brain. Scans of the brain should therefore be arranged on an emergency basis, as these will establish whether or not there is a build-up of fluid on the brain. Babies suspected of having hydrocephalus may require an ultrasound instead, while elderly patients may need a lumbar puncture.
Treating hydrocephalus
Anyone who develops hydrocephalus must undergo emergency surgery, during which a shunt (a thin tube) is inserted into the brain. The excess CSF can then run through this tube, out of the brain and into another area of the body – usually the abdominal cavity. The CSF is absorbed into the bloodstream as it normally would be.
The only possible exception to this is elderly people who have developed normal pressure hydrocephalus, as surgery may be too risky to undertake. Everyone else, however, needs to have surgery.
What happens if hydrocephalus is not treated?
Without treatment, the fluid will continue to build-up on the brain, causing an increasing amount of damage. Soon the patient will be left with long-term brain injuries, which can result in devastating complications such as impaired speech, loss of vision, learning disabilities, poor co-ordination, epilepsy and memory problems.
These injuries are of course devastating and will change the patient's life forever. The only way to avoid such a tragic outcome is to treat hydrocephalus without delay, before too much damage is sustained.
Blocked shunt and shunt malfunction
When a patient is fitted with a shunt, he/she/their family must be told that a blockage is possible.
A shunt can become blocked for a number of reasons. It may be that tissues or cells clog up the tube. A blockage can also arise as a result of an infection, during which the bacteria block the tube. Sometimes the shunt will become dislodged or will fracture, something which is more common in children who effectively outgrow their shunt. Occasionally a shunt will also malfunction due to a mechanical fault.
Medical practitioners should explain what symptoms might arise when a shunt becomes blocked, and should make it clear that the patient must return to hospital immediately if problems occur.
The symptoms of a blocked shunt are the same as those associated with hydrocephalus – namely headache, vomiting and blurred vision. A patient who presents with these symptoms, and who is known to have a shunt in place, should immediately be suspected of having a blocked or malfunctioning shunt. Emergency surgery must then be carried out to replace the shunt.
Failure to diagnose and treat a blocked shunt
If a blocked shunt is not quickly diagnosed and treated, the CSF will not be able to drain away properly, so will build-up and harm the brain. The patient will then be left with permanent brain damage, with potential consequences including seizures, psychosis, photophobia, headaches and physical disability.
If a delay in diagnosis and treatment is a result of medical error, there could be grounds for a medical negligence claim. Indeed, any competent clinician should be aware of the symptoms of a blocked shunt. If a patient is known to have a shunt and presents with these symptoms, the blockage should be suspected and treated immediately. It is not acceptable to send a patient home, to delay tests, or to postpone emergency surgery.
Failure to diagnose and treat hydrocephalus
There could also be grounds for a medical negligence claim if medical practitioners fail to diagnose and treat hydrocephalus. While a diagnosis might not be as obvious as a blocked shunt (where a patient is known to be at risk), doctors should be aware of the symptoms of hydrocephalus. This should lead to a timely diagnosis being made, followed by emergency surgery.
Speak to a solicitor about a hydrocephalus claim
If you or your loved one has suffered life-changing injuries because hydrocephalus or a blocked shunt was not diagnosed and treated, please get in touch with us at Glynns Solicitors. You could be entitled to pursue legal action against those at fault.
Call us free on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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