Hydrocephalus is an abnormal condition in which cerebrospinal fluid collects in the ventricles of the brain. In infants it causes abnormal rapid growth of the head, bulging of fontanels and a small face.

According to Dr Innocent Uwingabire of Gitega Health Centre, Kigali, researchers are yet to trace the exact cause of the disease.

He says the brain has the cerebral spinal fluids chamber that contains water, explaining that an infected chamber halts the water movement causing stickiness of fluids in the brain at one place due to blocked streams.

He adds that sometimes hydrocephalus causes loss of coordination, trouble in walking, muscle spasm, slowed growth to the children between 0-5 years and restricted movement.

He says patients experience an enlarged body due to the water content in the head which also affects the brain function through the nervous system transmission.

Dr. Charles Niwagaba, a pediatrician at Profemmes Twese Hamwe in Kigali, says the condition is either inborn or acquired after birth.

He says one of the main causes is the weak veins that cannot transfer water to other parts of the body which presents normally with malformations of the head shape, difficulty in feeding, excessive sleepiness, headache, irritability, poor temper control and Loss of bladder control (urinary incontinence).

Niwagaba adds that hydrocephalus is associated with other diseases like spinal bifida and club feet disease.

"Sometimes we advise mothers to abort when it’s discovered that an unborn child is infected with hydrocephalus and won’t heal easily,” he adds.

How mothers can prevent the disease?

Dr Brenda Asiimwe Kateera, who works with AIDs Healthcare Foundation (AHF) Rwanda, says hydrocephalus is not a preventable condition. However, there are ways to reduce the risk of hydrocephalus.

She says pregnant women should get regular prenatal care by follwoing their doctors’ schedules for checkups during pregnancy which reduces risks of premature labour that places the baby at risk of hydrocephalus.

She adds that preventing and promptly treating the infections and other illnesses associated with hydrocephalus like meningitis may reduce the risk.

Dr Uta Elisabeth Düll, the Gikonko Health Centre director, says that the exact cause is unknown but a pregnant woman’s lifestyle may cause the disease.

"That is why in the first trimester a pregnant woman is supposed to eat food rich in iron so that the body is equipped with body building foods and the right body nutrients,” she says.

Düll advises that prenatal consultations are very necessary where every pregnant woman should go for regular medical checkup so that the gynecologist can check for abnormalities of the unborn child.

Treatment

Dr Leon Muteesa, a gynecologist and clinical genetic specialist at Rwanda Military Hospital, says one of the possible treatment options is surgery to remove the blockage, if possible.

He adds that shunting is also another possible way of treatment where passage is made between two natural body channels, such as blood vessels, created surgically to divert or permit flow from one pathway or region to another.

"All shunts have a valve system which regulates the pressure of the cerebrospinal fluid and prevents backward flow of fluid into the ventricles,” says Muteesa.

D. Issabella Ntaganda of Ruli District Hospital, says there are six types of hydrocephalus, but the the common ones are mainly congenital and acquired hydrocephalus.

"Congenital hydrocephalus affects the child when there is excess cerebrospinal fluid in the brain at birth where the extra fluid increases the pressure in the baby’s brain causing damage, mental and physical problems. Acquired hydrocephalus, on the other hand, occurs after birth when a tumor, injury or disease blocks the absorption of cerebrospinal fluid in the brain,” she says.

Ntaganda adds that in most cases, congenital hydrocephalus attacks the infant prior to birth, causing them to develop hydrocephalus during foetal development, while acquired hydrocephalus comes as a consequence of infections such as meningitis, brain tumors and head trauma, among others.

Nuwagaba recommends that children should get regular check-ups to detect any intellectual, neurological, or physical problems.

"Visiting healthcare providers and social support groups can provide emotional support and assist with the care of a child with hydrocephalus who has significant brain damage,” he says.