Know First... Treatable Brain Edema in the Elderly

Many people wonder how hydrocephalus occurs… let’s take a look! Inside the brain ventricles, there is brain tissue surrounded by cerebrospinal fluid that nourishes and cushions to reduce impact when our body moves. Imagine when we put tofu in a travel container, why do we need to add water? It is to prevent the tofu from being damaged by the container during travel.

What causes hydrocephalus in the elderly?

It is caused by an imbalance between the production and absorption of fluid. Some cases have “less production than absorption”, resulting in too little fluid in the ventricles to nourish the brain, while others have “more production than absorption,” causing excessive fluid that often leads to a condition called “hydrocephalus”. It can be classified as follows:

1. Acute type usually presents with severe headache, nausea, vomiting; if the fluid accumulation is severe, it may cause loss of consciousness or death.
2. Chronic type may have intermittent headaches, blurred vision, and usually lacks symptoms seen in the acute type.
3. Normal pressure hydrocephalus occurs in patients with chronic hydrocephalus who adapt so that the brain pressure does not increase. When measured, the brain pressure is close to normal.

Early symptoms to watch for

Initially, patients often experience unsteady gait (gait apraxia), needing to hold onto one side to turn around. This symptom usually lasts about 1 year. If accompanied by dementia, patients often forget recent events, such as not remembering if they ate breakfast, but can recall long-term memories, which differs from Alzheimer’s disease. Patients with urinary incontinence will urgently need to use the bathroom or be unable to hold urine.

Treatment
Treatment involves inserting a shunt to drain excess fluid from the brain. It is a simple surgery that takes less than an hour, has low risk, and is effective. If symptoms do not improve sufficiently, it can still slow down brain degeneration for a long time.

However, the most important factor for patients to avoid future dementia is rapid, accurate, and precise diagnosis because this condition can be treated and prevented if addressed early. Therefore, children and grandchildren should regularly monitor the elderly’s symptoms and promptly take them to see a doctor if unsure.