My third ventricle has grown from 4 mm to 6 mm after an SAH. Why?

Question

Hi doctor,

I am currently abroad on vacation, and I had an important question, which could not wait until I saw my primary care neurologist when I am back home. Five months back, I was involved in a serious hit and run accident (me being the victim). I sustained numerous injuries, the most prevalent being a traumatic brain injury (SAH). I was released from the hospital after about a month and returned home to continue recovering with my family. After months of recovery and PT for my femur surgery, I am just now beginning to get back on my feet, and I am planning on returning to work as a professor at the end of next month. During my last neurological examination, the computed tomography (CT) scan found that my third ventricle has grown from 4 mm to 6 mm. This worries me tremendously since the research I have done online signifies that this may indicate hydrocephalus (attached is the radiologist findings). My question to you is, can my third ventricle enlargement be anything other than hydrocephalus? Is this a common occurrence after a traumatic subarachnoid hemorrhage (SAH) due to an accident? If it is indeed hydrocephalus, is the only treatment a shunt? Is there a less invasive treatment? I am really scared beyond words, and I am hoping that I do not end up with hydrocephalus. What is the usual timeline for the hydrocephalus to develop after SAH? I will be sure to get a full check-up once I see my neurologist in a few weeks, but I just cannot wait any longer for an answer. Thank you for your time.

Answer 1

Hi,

Welcome to icliniq.com. I read your query and understand your concerns. The other likely cause for enlargement of lateral ventricles includes injury to the brain tissue leading to vacuum effect on ventricular system and enlargement. However, considering no damage to other parts of the brain, I do not think this is a possible explanation for the observed findings in current computed tomography (CT) scan. Although, it is theoretically possible. Hydrocephalus is one of the common and incapacitating complications of all forms of SAH (subarachnoid hemorrhage) including traumatic one. There is some data, which suggest that almost 20 % of individuals with SAH tend to develop hydrocephalus in the long run. A shunt is the only option which shows proven effect although medication is one other option, which can be used but with limited effect. Having said this, I like to assure you that if there is further enlargement, medication can be considered as an initial treatment. I would also like to inform you that most hydrocephalus develops acutely and chances of developing hydrocephalus, in the long run, are very low. I hope this helps you. Feel free to write back to me if you have more questions. Thanks and regards.