By Moses Nampala
Three-week old Susan Akech has an abnormally big head — the size of a mature pumpkin. The abnormality has distorted her facial features.
Her mother, Agnes Nyadoi (28), a resident of Pabone C village, Iyolwa sub-county in Tororo district, says Akech was born normal.
“She was just a week old when her head suddenly started to swell. The medical workers at Iyolwa Health Centre III referred me to Mbale Hospital for specialised care,” says Akech.
According to the medical forms issued by Mbale Hospital, Akech requires surgery to correct the deformity. However, Nyadoi cannot afford it. “I decided to return home with my child because I could not raise the over sh800,000 for the surgery,” she says.
Tororo district health officer Dr. David Okumu says Akech’s condition is called hydrocephalus.
What is hydrocephalus?
Okumu defines hydrocephalus as a continuous build-up of fluid in the skull, causing the head to swell.
“The brain is cushioned by a fluid called cerebrospinal fluid, which flows through the skull and spinal cord. Under normal circumstances, when the volume of the fluid increases, it is absorbed in the blood stream.
However, according to Tororo Hospital superintendent Dr. Andrew Opete, when the excess fluid can no longer be absorbed in the blood stream, it accumulates in the head, causing it to swell.
Numerous factors can cause hydrocephalus. The baby could have been injured before, during and after birth. For instance, unqualified health personnel may injure the head of an infant, causing hydrocephalus.
“The child may also develop the condition as a result of an infection the mother contracted during pregnancy,” explains Opete.
Okumu says hydrocephalus could also be genetic.
On the other hand, the abnormality could develop when the child is still in the womb, if a tumour develops in the central nervous system, including the brain.
The most common visible symptom of hydrocephalus is a swollen head that is tender and fragile. “Consequently, the eyes sink deep into the sockets, and they tend to appear dazed,” Okumu explains.
The medical remedy usually involves draining the fluid. “The patient has to be subjected to a surgical operation, where a tube (shunt) is fixed in the head, connected to the other parts of the body, particularly the belly,” Opete explains.
The tube allows the excess fluids in the head to drain, subsequently regulating the flow and reducing the build-up.
The infant can also be subjected to another medical intervention referred to as endoscopic third ventriculostomy. “This intervention is not common in Africa because many hospitals are ill-equipped to handle it,” explains Opete.
It works by relieving and stabilising the fluid without necessarily subjecting the child to surgery.
Okumu and Opete both argue that regular scans during pregnancy are a necessity, especially if the abnormality runs in the family.
The problem could be detected early, and the mother would be advised accordingly.
Mothers are also advised to attend antenatal clinics regularly.