Social Security Disability Lawyers: Riverside and San Bernardino & Orange County
Hydrocephalus is an accumulation of increased fluid (“cerebrospinal fluid” or “CSF”) within the cavities (“ventricles”) of the brain. The term comes from the Greek words “hydro” (water) and “cephalus” (head), or “water on the brain.” The fluid that accumulates is cerebrospinal fluid, which nourishes the brain with proteins and nutrients as it circulates throughout the brain and spinal cord.
Hydrocephalus may cause increased pressure inside the brain, which can result in neurological damage. Symptoms include headaches, visual problems, cognitive impairment, incoordination, and incontinence
Hydrocephalus is most common in children and older adults, but it can occur in a wide range of people, from infants and older children to young, middle-aged and older adults. The Hydrocephalus Association estimates that >700,000 Americans have hydrocephalus. [Ref: https://www.hydroassoc.org/hydrocephalus/]
Types of Hydrocephalus
When hydrocephalus occurs in children, it typically presents as “congenital hydrocephalus,” which is present at birth as a result of genetic or fetal developmental problems. When hydrocephalus occurs in adults, it is referred to as “acquired hydrocephalus,” which may be the result of various types of injury or disease.
Hydrocephalus can be divided into “communicating” or” non-communicating” types. In “communicating hydrocephalus,” the CSF is able to flow between the ventricles of the brain, but in “non-communicating hydrocephalus,” the flow of CSF is obstructed at some point within the ventricular system (often because of an anatomical narrowing between the third and fourth ventricles.)
Additionally, there is a type of hydrocephalus called “hydrocephalus ex-vacuo,” which occurs following a stroke or a traumatic brain injury. In this type of hydrocephalus, there is a shrinkage of the brain tissue that causes the ventricles to “enlarge.”
Finally, there is “normal pressure hydrocephalus” (“NPH”), which is an abnormal increase of cerebrospinal fluid in the brain's ventricles. This can occur following some sort of injury to the brain (e.g., bleeding within the brain, injury, infection, brain tumor, or surgery), but in approximately 375,000 Americans who have NPH, there is no apparent cause. [Ref: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Hydrocephalus-Fact-Sheet]
Causes of Hydrocephalus
In many patients who have hydrocephalus, the cause is not well understood. Genetic abnormalities, developmental problems in utero, spina bifida, prematurity, meningitis, traumatic brain injury, and brain tumors have all been associated with hydrocephalus.
Diagnosis of Hydrocephalus
Hydrocephalus is typically diagnosed by imaging studies of the brain, such as CT or MRI scans. Neurologists and neurosurgeons are the types of doctors who specialize in the diagnosis and treatment of hydrocephalus.
Symptoms and Complications of Hydrocephalus
When congenital hydrocephalus occurs in infants, the brain and head swell, and there can be a rapid increase in the circumference of the head because the bones of the skull have yet to fuse. Symptoms often include nausea, vomiting, sleepiness, or seizures.
In older children, the skull is fused and cannot expand due to the increased pressure from hydrocephalus. Symptoms can include headache, problems with gait, balance and coordination, problems with bladder and bowel control, neurological deficits, and cognitive dysfunction or memory loss.
In adults, these and other problems can occur, including progressive dementia. Patients with progressive hydrocephalus can become physically and mentally disabled and may not be able to perform even sedentary work.
Treatment of Hydrocephalus
Treatment of hydrocephalus depends on the type of hydrocephalus, the age of the patient, and many other factors, and the results of treatment are variable. Some patients do very well with early treatment, while others have poor outcomes.
Hydrocephalus is most often treated by surgically inserting a flexible plastic tube with a one-way valve that drains CSF from a ventricle inside the brain to the abdominal cavity, where it is absorbed back into the circulation.
Shunts can be problematic. Sometimes they don't work well because of mechanical problems. Problems can arise if they drain too much CSF, which can then cause collapse of the ventricles, tears to the brain, and other complications. Shunts may drain too little CSF, in which case the symptoms of hydrocephalus get worse.
Disability Benefits for Hydrocephalus
A diagnosis of hydrocephalus is not enough to “automatically” qualify for Long-Term Disability (LTD) benefits under either the Social Security Disability (SSDI) program or under an employer-provided group disability plan (ERISA). That's because symptoms and complications related to hydrocephalus vary from person to person, and the degree to which these symptoms (both physical and cognitive) impair functional capacity will vary as well.
The Social Security Administration (SSA) does not include hydrocephalus in its “Blue Book” of recognized disabilities. However, it may be possible to “equal” a disability rating under one or more of the following: Stroke or Traumatic Brain Injury – Section 11.04, Traumatic Brain Injury – Section 11.18, Epilepsy – Sections 11.02 and 11.03, and Organic Mental Disorders – Section 12.02.
A well-documented history, neurological examination, objective documentation of hydrocephalus with imaging studies of the brain, and neurocognitive testing may help provide objective evidence of physical and cognitive impairment to enable a benefit award.
At Law Med, we are SSDI and ERISA knowledgeable and experienced, and we work with your doctor to get you SSDI and ERISA disability benefits.