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Diving into “Water on the Brain” Hydrocephalus: An Exploration

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  1. Basic pathology
  2. Specific types and respective etiologies
  3. Causes
  4. Symptoms
  5. Demographics and epidemiology
  6. Possible treatment
  7. Prognosis
  8. Diagnostic concerns
  9. Conclusion
  10. References

The popular board game Operation entails the treatment of, amongst many other ersatz medical conditions, ?water on the knee,? cleverly rendered as a bucket to be withdrawn from the knee of the plastic ?patient? using tweezers. However, to the dismay of many seven-year old budding neuropsychologists, there was no ailment involving the most important part of the body: the brain. Perhaps that bucket should have been reserved for a niche in the patient's head instead of his knee, since the condition colloquially-termed ?water on the brain,? or hydrocephalus, is not only more detrimental to the overall functioning of an individual than knee-pain, but, according to the National Institute of Neurological Disorders and Stroke, affects one of every 500 children born and is the leading cause for childhood brain surgery (2008).

[...] Effects of intraventricular hemorrhage and hydrocephalus on the long-term neurobehavioral development of preterm very- low-birthweight infants. Developmental Medicine & Child Neurology, 596-606. Retrieved April from PsycINFO database. References (continued) Foss, T., Eide, P., & Finset, A. (2007). Intracranial Pressure Parameters in Idiopathic Normal Pressure Hydrocephalus Patients with or without Improvement of Cognitive Function after Shunt Treatment. Dementia and Geriatric Cognitive Disorders, 47-54. Retrieved April from PsycINFO database. Graff-Radford, N. (2007, August). Normal pressure hydrocephalus. Neurologic Clinics, 809-832. Retrieved April from PsycINFO database. [...]


[...] The specific diagnostic tool is chosen based on the individual, i.e. age, other clinical diagnoses, and the presence of known central nervous system abnormalities. However, diagnosis is not simple, as the plethora of possible symptoms often manifest themselves similarly to other disorders. In a case study performed by Reisch, Brekenfeld and Barth, a 22 year-old male was presenting manic and depressive symptoms over the course of a two-year period; however, the patient displayed no neurological symptoms (2005). However, three months after initial evaluation, the patient was imaged via MRI and shown to have an obstructive hydrocephalus. [...]


[...] A valve on the catheter maintains one-way flow and regulates the flow, so an extreme drainage of CSF fluid does not occur. Shunts are not the perfect treatment, however. For example, the installation of a shunt in a child will require the eventual lengthening and modification of the shunt system, as children grow rapidly. Furthermore, being a foreign mechanical device introduced into the body, failure is possible, as are infection and inflammation. The shunt system, like the body's own drainage system, also has the possibility of becoming obstructed (Ogden, 1986). [...]

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