Hydrocephalus

Cerebrospinal fluid normally circulates sequentially through the four ventricles of the brain and then passes into the large veins on top of the brain where it is reabsorbed. Hydrocephalus occurs when there is too much cerebrospinal fluid (CSF) within the ventricles, resulting in excess pressure in the brain. A child can be born with hydrocephalus (congenital) or develop the condition during or after birth (acquired).

The brain constantly makes cerebrospinal fluid. CSF is normally absorbed into the blood and carried out of the brain as new CSF is made. In hydrocephalus, the CSF continues to build up in the brain and can cause brain injury.

Signs & Symptoms

Signs and symptoms of hydrocephalus vary depending on a patient’s age and other underlying conditions. In babies these signs and symptoms include:

  • Rapid increase of head circumference
  • Bulging of soft spot on a baby’s head (fontanelle)
  • Sleepiness
  • Irritability
  • Vomiting
  • Downward-gazing eyes
  • Seizures

Signs and symptoms in older children and adults include:

  • Headache
  • Nausea and vomiting
  • Clumsiness
  • Downward-gazing eyes
  • Sleepiness and irritability
  • Blurred or double vision
  • Incontinence
  • Personality changes
  • Balance changes

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Causes & Risks

The most common cause of congenital hydrocephalus is a blockage between two ventricles that prevents CSF from moving through the brain. Many other types of brain development problem can cause hydrocephalus such as:

  • Spinal cord abnormalities
  • Brain cysts
  • Infections during pregnancy
  • Genetic disorders

Causes of acquired hydrocephalus include:

  • Bleeding in the brain
  • Head injury
  • Brain tumors
  • Brain infections (meningitis)

Risks of developing congenital hydrocephalus include:

  • Family history of congenital hydrocephalus
  • Poor prenatal care during pregnancy
  • Diabetes present during pregnancy

Diagnosis & Treatment

Hydrocephalus is diagnosed with a physical exam, medical history and brain imaging tests including an MRI or CT scan. Congenital hydrocephalus can be diagnosed before birth using a fetal ultrasound during pregnancy.

Surgery is the only treatment for hydrocephalus. The most common type of surgery is the placement of a flexible tube (shunt) in the brain or spinal cord to drain the fluid into another part of the body. The shunt may need to be adjusted or replaced over time as your child grows.