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Sioux Valley High School
Novel Unit
The Absolutely True Diary of a Part-time Indian
By Sherman Alexie
Hydrocephalus - Water on the brain
http://www.ncbi.nlm.nih.gov
Hydrocephalus is a buildup of fluid inside the skull, leading to brain swelling. Hydrocephalus
means "water on the brain."
Causes, incidence, and risk factors
Hydrocephalus is due to a problem with the flow of cerebrospinal fluid (CSF), the liquid that
surrounds the brain and spinal cord. The fluid brings nutrients to the brain, takes away waste
from the brain, and acts as a cushion.
CSF normally moves through areas of the brain called ventricles, then around the outside of the
brain and the spinal cord. It is then reabsorbed into the bloodstream. Buildup of CSF can occur
in the brain if its flow or absorption is blocked or if too much CSF is produced.
This buildup of fluid puts pressure on the brain, pushing the brain up against the skull and
damaging or destroying brain tissues.
Hydrocephalus may start while the baby is growing in the womb. It is commonly present with
myelomeningocele, a birth defect involving incomplete closure of the spinal column. Genetic
defects and certain infections that occur during pregnancy may also cause hydrocephalus.
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In young children, hydrocephalus may also be associated with the following conditions:
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Infections that affect the central nervous system (such as meningitis or encephalitis),
especially in infants
Bleeding in the brain during or soon after delivery (especially in premature babies)
Injury before, during, or after childbirth, including subarachnoid hemorrhage
Tumors of the central nervous system, including the brain or spinal cord
Injury or trauma
Symptoms
The symptoms depend on the cause of the blockage, the person's age, and how much brain tissue
has been damaged by the swelling.
In infants with hydrocephalus, CSF fluid builds up in the central nervous system, causing the
fontanelle (soft spot) to bulge and the head to be larger than expected. Early symptoms may also
include:
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Eyes that appear to gaze downward
Irritability
Seizures
Separated sutures
Sleepiness
Vomiting
Symptoms that may occur in older children can include:
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Brief, shrill, high-pitched cry
Changes in personality, memory, or the ability to reason or think
Changes in facial appearance and eye spacing
Crossed eyes or uncontrolled eye movements
Difficulty feeding
Excessive sleepiness
Headache
Irritability, poor temper control
Loss of bladder control (urinary incontinence)
Loss of coordination and trouble walking
Muscle spasticity (spasm)
Slow growth (child 0 - 5 years)
Slow or restricted movement
Vomiting
Signs and tests
When a health care provider taps fingertips on the skull, there may be abnormal sounds that
indicated thinning and separation of skull bones. Scalp veins may appear stretched or enlarged.
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Part or the entire head may be larger than normal. Enlargement is most commonly seen in the
front part of the head. Head circumference measurements, repeated over time, may show that the
head is getting bigger.
The eyes may look "sunken in." The white part of the eye may appear above the colored part of
the eye, given the eyes a "setting-sun" appearance. Reflexes may be abnormal.
Sherman Alexie
Sherman Alexie Birth:
Sherman Alexie was born on October 7, 1966 on the Spokane Indian Reservation in Wellpinit,
Washington.
Sherman Alexie Background:
Sherman Alexie, the son a Spokane Indian mother and a Coeur d’Alene Indian father, was born
hydrocephalic (with water on the brain) and at six months underwent a brain operation from
which he was not expected to survive. He did more than that. Despite the resulting childhood
seizures, Alexie turned out to be an advanced reader and was purportedly reading novels like The
Grapes of Wrath at the age of five.
As a teenager enrolled in the reservation schools, Alexie found his mother's name written in a
textbook assigned to him. Determined not to spend his life on the reservation, he sought a better
education at the high school in Reardon, Washington, where he was the only Indian, a top
student and a star basketball player. Upon graduation in 1985, Alexie attended Gonzaga
University on a scholarship from which he transferred to Washington State University after two
years to study pre-med.
Fainting spells in anatomy class convinced Alexie to change his major, a decision reinforced by a
love of poetry and an aptitude for writing. He graduated with a Bachelors degree in American
Studies and shortly thereafter received the Washington State Arts Commission Poetry
Fellowship and the National Endowment for the Arts Poetry Fellowship. As a young man,
Alexie struggled with alcoholism but gave up drinking at the age of 23 and has been sober since.