Hydrocephalus

I've said many times, I wish I could draw you a picture when I talk about the shunt and fluid buildup because I know its hard to understand. Here's a picture of a brain with hydrocephalus (left) and a normal brain (right). This is looking down from the top of the head. The black part is spinal fluid, the white around it is healthy brain tissue. When I've talked about tissue compression and the brain matter bouncing back (as the shunt has been able to relieve fluid), I am referring to the white matter. The excess fluid can push the "good" tissue against the skull and compress it like a sponge. When it is relieved over time, the tissue can bounce back. Or, the fluid can be taking the place of missing brain tissue that was damaged during the brain bleed.

If a shunt malfunctions, the fluid will build up again causing a lot of problems after the baby's skull has fused and the fontanelle is no longer soft. When they are tiny babies, the excess fluid will actually make the head expand so it is not necessarily as urgent when there is buildup as in a child over 9 months.

There is no way to know how much will drain out vs. missing tissue until another year or so. In Lucas's case, it looked a lot like this picture when we started this last summer (worse than this picture on the right side of his brain). When he had surgery a couple months ago, there was a circle of fluid on the left that was pushing up against the brain stem (causing all the central apnea). Today, the left side has drained completely and is finally considered normal, but the right is still very full. We know the tissue is definitely gone from the bleed in the right front and middle, but we are still waiting to see the full impact.