The excessive fluid increases pressure inside the skull, affecting the brain’s ability to function normally.
CSF is a clear fluid that bathes and cushions the brain, protecting and providing it with vital nutrients.
CSF flows around the spinal cord and through the brain’s ventricles before being reabsorbed into the bloodstream.
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Congenital hydrocephaluscan be brought on by inherited genetic abnormalities or developmental disorders affecting the brain’s CSF flow.
Acquired hydrocephalus in babiesis most commonly brought on by a brain bleed, often due toprematurity.
In around half of NPH cases, the cause remains unknown.
Hydrocephalus ex-vacuois usually due to astrokeor an injury to the brain.
It may also occur in older individuals whose brain shrinks with age or in those withAlzheimer’s disease.
Diagnosis
The diagnosis of hydrocephalus starts with a detailed medical history andneurological exam.
Imaging tests and a spinal tap are also vital diagnostic tools.
In some cases, intracranial pressure monitoring may be required.
A thin needle is placed into the person’s lower back.
Spinal taps can also be therapeutic because they often temporarily relieve a person’s hydrocephalus symptoms.
ICP monitoring is performed in the hospital by aneurosurgeon(a surgeon who treats nervous system conditions).
It requires the placement of a catheter (a thin tube) through the skull into the brain.
The catheter measures the CSF pressure.
Treatment
Hydrocephalus is a serious condition that is treated with brain surgery.
That said, surgery is not a cure.
Instead, it helps relieve symptoms and lower the pressure in the skull.
This allows CSF to be aspirated from the reservoir rather than by lumbar puncture.
Shunt surgery may still required after initially managing hydrocephalus with an Ommaya reservoir.
Duringshunt surgery, a neurosurgeon places the shunt through an opening in the skull into the ventricle.
Are Shunts Permanent?
Additional shunt surgery may be needed if the shunt malfunctions.
Children with hydrocephalus who receive a shunt will need multiple surgeries over their lifetime as they grow.
Endoscopic Third Ventriculostomy
Sometimes, a surgery called endoscopic third ventriculostomyis performed.
This hole creates a pathway for the excess CSF to flow in and around the brain.
Others may not experience improvement for weeks or months.
For some people, one or more symptoms may persist or recur.
Ultimately, there is no way to predict precisely how beneficial surgery will be for anyone.
Early rehabilitation therapy can help children improve, adapt, and cope with development or physical impairments.
Summary
Hydrocephalus is associated with the abnormal buildup of cerebrospinal fluid within the brain’s ventricles.
Babies with hydrocephalus may have unusually large heads.
Older children and adults typically develop symptoms like headaches and vision problems.
The diagnosis of hydrocephalus involves a brain imaging test, like an ultrasound or MRI.
Treatment consists of brain surgery, typically placing a shunt in the brain to drain the excess CSF.
A Word From Verywell
Hydrocephalus is a complex, lifelong condition.
The upside is that a good, if not great, recovery is possible with early diagnosis and treatment.
National Institute of Neurological Disorders and Stroke.Hydrocephalus fact sheet.
American Association of Neurological Surgeons.Adult-onset hydrocephalus.
National Organization of Rare Diseases.Hydrocephalus.
Tully HM, Dobyns WB.Infantile hydrocephalus: a review of epidemiology, classification and causes.Eur J Med Genet.
2016;207:188-192. doi:10.1016/j.ejogrb.2016.11.007
Oliveira LM, Nitrini R, Roman GC.Normal-pressure hydrocephalus: a critical review.Dement Neuropsychol.
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