Hello, tapper-ga,
Thanks for your question.
A question and answer from the Neurology and Neurosurgery forum at
MedHelp International, addresses one cause of fluid at the base of the
brain, not caused by hydrocephalus.
Question: “What causes spinal fluid to leak into the base of the
brain? Over a period of three to four years what kind of damage can
this do? And lastly, what can be done to correct this?”
Answer: “The entire brain is surrounded by spinal ( or cerebro-spinal
fluid CSF, as it is more correctly called ). I presume that you are
referring to leak of fluid from the skull base.
This can occur whenever the skull bones are breached , either by
surgery, trauma or another process which erodes away a piece of bone
leaving a defect through which fluid can leak out.
Sometimes this seems to occur spontaneously and a cause is never
found, possibly due to some congenital anatomical anomaly.
The actual leak itself is not harmful, and will not cause any long
term damage.
The danger is that at any time if fluid can leak out then infection
can potentially get in, causing meningitis.
A constant leak can cause low CSF pressure which can lead to chronic
headaches.
This sort of leak would probably require surgical correction, as it
is not likely to close spontaneously after this time period.”
Please refer to website at
http://www.medhelp.org/forums/neuro/messages/30131a.html
A type of fluid buildup can also occur after an aneurysm. I know you
said it is not a “bleed”, or stroke, but this refers to the buildup of
fluid after an aneurysm has occurred and blood has leaked into the
cerebrospinal fluid. Though termed “hydrocephalus,” it is actually
caused by the initial aneurysm.
“Fluid Buildup in the Brain
Blood from a torn aneurysm can block CSF circulation. This can lead
to fluid buildup and increased pressure on the brain. The open spaces
in the brain, called ventricles, may enlarge. This is known as
hydrocephalus. It can make a patient lethargic, confused, or
incontinent. Fluid may also build up in the brain after surgery. To
stop fluid buildup, a drain may be placed in the ventricles. This
removes leaked blood and trapped CSF.”
Please read “Brain Aneurysm Basics.” Brain Aneurysm Foundation. (2002)
at http://www.bafound.org/subarachnoidhemorrhage.htm
“Dandy-Walker Cysts” can block the ventricles at the base of the
brain and lead to a buildup of Cerebrospinal fluid. “Other types of
hydrocephalus can be due to obstruction by cysts in the ventricles.
Dandy-Walker cysts, which block the fourth ventricle at the base of
the brain are an example of these swellings.” While considered a
“type” of hydrocephalus, there is a distinction about the causes and
types of such a condition. “Finally, hydrocephalus is often classified
as either communicating or non-communicating. In the first type, the
problem is usually failure to absorb the CSF at the end of the system,
whereas in the second there is blockage of the CSF pathways within the
ventricular system.”
Refer to “Hydrocephalus.” Association for Spina Bifida and
Hydrocephalus at http://www.asbah.org/baystart1.html
Another explanation of the Dandy-Walker malformation is excerpted
here:
“The Dandy-Walker malformation is marked by incomplete formation, or
absence of, the central section of the cerebellum, and the growth of
cysts within the lowest of the brain's ventricles. The ventricles are
fluid-filled cavities within the brain, through which cerebrospinal
fluid (CSF) normally circulates. The cysts may block the exit of the
fluid, causing hydrocephalus. Symptoms may be present at birth or
delayed until early childhood.” Read “Congenital Brain Defects.”
Joseph Smith Medical Library(9/15/2002) at
http://www.chclibrary.org/micromed/00043570.html
Chiari Malformations alone, or combined with Syringomyelias, are also
associated with fluid at the base of the brain. Chiari malformations
are protrusions of the lower portion of the brain into the spinal
canal. They can be associated with hydrocephalus or syringomyelias,
which involve excessive fluid in the spinal cord.
“Most patients with Chiari malformations are without symptoms. When
symptoms are present, they usually do not appear until adolescence or
early adulthood. Headache and neck pain are the most commonly reported
symptoms.
The affected regions of the brain are the lower brainstem and
cerebellum. The lower brainstem controls breathing, swallowing,
balance, the vocal cords, eye movements, and sensation and movement of
the arms and legs. The cerebellum's most important function is to
coordinate body movements.
Some individuals with Chiari malformations report vertigo
(dizziness), headaches caused by coughing, weakness in their arms, a
burning-like pain in the arms, severe curvature of the spine and other
symptoms. The severity of symptoms is often associated with the degree
of pressure on this portion of the brain. Therefore an individual with
a "small Chiari malformation" may have very mild symptoms or no
symptoms at all. Some individuals with Chiari malformation never
develop symptoms. Symptoms of a Chiari malformation are often vague
and diagnosis of a Chiari malformation is frequently delayed.”
Please read the entire article, “Chiari Malformations and
Syringomyelia Fact Sheet,”
Prepared by the Center for Human Genetics, Duke University Medical
Center, Durham, NC (2000) at
http://www.chg.duke.edu/patients/facts.html
Also read “Chiari Type I Malformations.”
Neurosurgery://On-Call.(06/2001) at
http://www.neurosurgery.org/health/patient/answers.asp?DisorderID=74
The above references should give you a good start on some answers.
It seems that the first reference from the Neurology and Neurosurgery
forum, concerning the leakage of Cerebrospinal fluid, is an extremely
interesting lead about possible causes of fluid retention at the brain
base.
Let me know if I can be of further help!
umiat-ga
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