Ma Aye Htwe holds her daughter following treatment for hydrocephalus at Yangon General Hospital. Pic: Aye Zaw Myo

HELP is at hand for the victims of hydrocephalus – water on the brain – a condition that affects children and adults and which, though treatable, is often ignored in Myanmar. Left untreated, the disease can cause severe health problems and lead to death.

Ma Aye Htwe brought her seven-year-old daughter from her home in Pakokku township, Magwe Division, to Yangon General Hospital for treatment after hearing that an operation could be performed to cure her. The girl has never been to school.

“We didn’t know our daughter could be treated until a friend told us about the operation,” she said. “My daughter was treated last November when they surgically inserted a shunt.” She later returned for a second operation.

Ma Yin Shwe, from Pyapon, Ayeyarwady Division, said she had been in Yangon for a month while her five-year-old son is treated at YGH.

“At two months, the baby’s head was growing bigger and bigger. Although he wanted to sleep on front he could not. He cried a lot at night and slept all day.”
She said she decided to go to a doctor when her son was five months old, and he was diagnosed with hydrocephalus.

“The Pyapon hospital referred us to YGH. We’ve been here a month, and the swelling has receded,” he said.

Dr Myat Thu, associate professor and head of YGH’s Department of Neurosurgery, said hydrocephalus resulted in the excessive accumulation of fluid in the brain.

“Congenital hydrocephalus needs to be treated as soon as possible,” he said.

According to the National Institute of Neurological Disorders and Stroke, congenital hydrocephalus may be caused by events or influences that occur during foetal development, or by genetic abnormalities. Other possible causes include complications of premature birth such as intraventricular haemorrhage, diseases such as meningitis, tumours, or traumatic head injury.
Prof Dr Myat Thu said hydrocephalus could affect individuals at all ages, and the symptoms vary with age.

The National Institute of Neurological Disorders and Stroke said that in infancy, the most obvious indication of hydrocephalus is a rapid increase in head circumference or an unusually large head size. Other symptoms may include vomiting, sleepiness, irritability, downward deviation of the eyes and seizures.

For older children and adults, although their skulls cannot expand like those of young children, symptoms may include headache followed by vomiting, nausea, blurred or double vision, problems with balance, poor coordination, gait disturbance, urinary incontinence, slowing or loss of developmental progress, lethargy, drowsiness, irritability, or other changes in personality or cognition including memory loss.

Dr Myat Thu said that if people suffer those symptoms they should seek medical attention.

“Once the disease is diagnosed, hydrocephalus can be treated by surgically inserting a shunt system,” he said.

The system diverts the flow of cerebrospinal fluid from the central nervous system to another area of the body where it can be absorbed as part of the normal circulatory process.

He said the disease was mostly found in poor families unaware that it could be treated and cured if caught in time.

The Joseph Lynch Children’s Fund started a shunt donation program in the Department of Neurosurgery of YGH through the International Friendship Group based in Yangon in 2002.

Ms Gill Pattison, the president of the International Friendship Group, said the fund had raised nearly US$24,000 for buying shunts, and some new equipment for the operating theatre.

“If hydrocephalus is not treated, it leads to brain damage and death. If treated with a shunt system, the child can lead a normal life,” she said.

She said the shunt costs about $60, which is expensive for a poor family. The fund has donated 210 shunts to YGH for poor families.

“People are not aware that they can get a free shunt here. The fund has plans to donate more shunts to YGH,” Ms Pattison said.