Failure to Diagnose Hydro…

If you've ever heard of someone having "water on the brain," you've heard a common name for hydrocephalus, a word that actually comes from the Greek words for "water" and "head." But the fluid involved in hydrocephalus is not merely water; it is cerebrospinal fluid (CSF), and if not properly diagnosed and treated, it can have serious consequences. While hydrocephalus can occur in patients of various ages for a variety of reasons, it can cause significant issues for newborns and infants. By the estimate of the National Institute of Neurological Disorders and Stroke (NINDS) 1 to 2 out of every 1,000 babies are born with hydrocephalus. That may not seem like a lot, but it matters because failure to diagnose hydrocephalus can have permanent consequences. If it's your baby who develops hydrocephalus and is not promptly and properly diagnosed, serious complications resulting in lifelong complications can occur.

What Hydrocephalus is and How it Happens

Cerebrospinal fluid, which is produced continually, is vitally important to brain health. It cushions the brain within the skull, acting as a "shock absorber," it conveys nutrients to brain tissue and carries away waste; and makes up for any changes in the volume of blood within the brain. If a person has a medical condition that interferes with the flow of CSF, or with its normal reabsorption, an excess of CSF can build up.

When CSF builds up, it causes spaces in the brain, called ventricles, to expand more than they should, and causes the brain to swell. The pressure caused by the excess of fluid against brain tissue results in hydrocephalus.

Hydrocephalus in infants is either congenital or acquired. Congenital hydroephalus may be caused by genetic abnormalities or influences that arise while the fetus is developing. Acquired hydrocephalus develops at or after birth. It is usually the result of physical trauma or disease. Depending on whether the flow of CSF within the brain is obstructed, hydrocephalus may be referred to as "communicating" or "obstructive."

What Happens When Hydrocephalus is Not Diagnosed

While the prognosis for babies with hydrocephalus is somewhat difficult to predict, it is probably that a delay in diagnosis in treatment is associated with a higher risk of negative outcome, including developmental delays and permanent brain damage. With early diagnosis and treatment, the chances for a good recovery are much improved.

The sooner the condition is diagnosed, the sooner treatment can be put in place. Treatment typically involves placement of a shunt, a strong but flexible tube, to divert CSF to an area of the body where it can be reabsorbed, relieving pressure on the brain.

Hydrocephalus in infants may not be immediately apparent; the sutures in their skulls have not fused, meaning the skull can expand slightly to accommodate the increased volume of CSF. However, that doesn't mean it's undetectable. Infants should have their head circumference measured regularly during their first year of life. A head circumference in an increasingly high percentile relative to other infants of the same age should alert a pediatrician that hydrocephalus is a possibility.

Other signs of hydrocephalus in infants include an unusually large head and bulging of the fontanel (soft spot). Infants with hydrocephalus may also experience unusual vomiting, excessive sleepiness, irritability seizures, poor feeding, and deficits in muscle tone and strength. Eyes that are fixed in a downward position (also known as sunsetting).

Failure to promptly diagnose hydrocephalus in infants may constitute medical malpractice. If you believe that your child's doctor missed signs of hydrocephalus, and that your child's prognosis is poorer as a result of a delayed or missed diagnosis, consult an experienced Oregon medical malpractice attorney. The cost of caring for a child with developmental delays or deficits can be significant, and your child may be entitled to compensation that allows them to have a better quality of life.

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