Hydrocephalus

By Medically reviewed by hellodoktor

Definition

What is hydrocephalus?

Hydrocephalus is the buildup of fluid in the cavities (ventricles) deep within the brain. The excess fluid increases the size of the ventricles and puts pressure on the brain.

Cerebrospinal fluid normally flows through the ventricles and bathes the brain and spinal column. But the pressure of too much cerebrospinal fluid associated with hydrocephalus can damage brain tissues and cause a large spectrum of impairments in brain function.

How common is hydrocephalus?

Although hydrocephalus can occur at any age, it’s more common among infants and older adults. The National Institute of Neurological Disorders and Stroke (NINDS) estimates that 1 to 2 of every 1,000 babies are born with hydrocephalus. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of hydrocephalus?

The signs and symptoms of hydrocephalus vary generally by age of onset.

Infants

Common signs and symptoms of hydrocephalus in infants include:

  • Changes in the head
    • An unusually large head
    • A rapid increase in the size of the head
    • A bulging or tense soft spot (fontanel) on the top of the head
  • Physical symptoms
    • Vomiting
    • Sleepiness
    • Irritability
    • Poor feeding
    • Seizures
    • Eyes fixed downward (sunsetting of the eyes)
    • Deficits in muscle tone and strength, responsiveness to touch, and expected growth

Toddlers and older children

Among toddlers and older children, signs and symptoms may include:

  • Physical symptoms
    • Headache
    • Blurred or double vision
  • Physical signs
    • Abnormal enlargement of a toddler’s head
    • Sleepiness
    • Difficulty remaining awake or waking up
    • Nausea or vomiting
    • Unstable balance
    • Poor coordination
    • Poor appetite
    • Seizures
  • Behavioral and cognitive changes
    • Irritability
    • Change in personality
    • Problems with attention
    • Decline in school performance
    • Delays or problems with previously acquired skills, such as walking or talking

Young and middle-aged adults

Common signs and symptoms in this age group include:

  • Headache
  • Difficulty in remaining awake or waking up
  • Loss of coordination or balance
  • Loss of bladder control or a frequent urge to urinate
  • Impaired vision
  • Decline in memory, concentration and other thinking skills that may affect job performance

Older adults

Among adults 60 years of age and older, the more common signs and symptoms of hydrocephalus are:

  • Loss of bladder control or a frequent urge to urinate
  • Memory loss
  • Progressive loss of other thinking or reasoning skills
  • Difficulty walking, often described as a shuffling gait or the feeling of the feet being stuck
  • Poor coordination or balance
  • Slower than normal movements in general

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

Seek emergency medical care for infants and toddlers experiencing these signs and symptoms:

  • A high-pitched cry
  • Problems with sucking or feeding
  • Unexplained, recurrent vomiting
  • An unwillingness to bend or move the neck or head
  • Breathing difficulties
  • Seizures

Seek prompt medical attention for other signs or symptoms in any age group.

Because more than one condition can result in the problems associated with hydrocephalus, it’s important to get a timely diagnosis and appropriate care.

Causes

What causes hydrocephalus?

Hydrocephalus is caused by an imbalance between how much cerebrospinal fluid is produced and how much is absorbed into the bloodstream.

Cerebrospinal fluid is produced by tissues lining the ventricles of the brain. It flows through the ventricles by way of interconnecting channels and eventually flows into spaces around the brain and spinal column. It’s absorbed primarily by blood vessels in tissues near the base of the brain.

Cerebrospinal fluid plays an important role in brain function by:

  • Keeping the brain buoyant, allowing the relatively heavy brain to float within the skull
  • Cushioning the brain to prevent injury
  • Removing waste products of the brain’s metabolism
  • Flowing back and forth between the brain cavity and spinal column to maintain a constant pressure within the brain — compensating for changes in blood pressure in the brain

Excess cerebrospinal fluid in the ventricles occurs for one of the following reasons:

  • The most common problem is a partial obstruction of the normal flow of cerebrospinal fluid, either from one ventricle to another or from the ventricles to other spaces around the brain.
  • Poor absorption. Less common is a problem with the mechanisms that enable the blood vessels to absorb cerebral spinal fluid. This is often related to inflammation of brain tissues from disease or injury.
  • Rarely, the mechanisms for producing cerebrospinal fluid create more than normal and more quickly than it can be absorbed.

Risk factors

What increases my risk for hydrocephalus?

There are many risk factors for hydrocephalus, such as:

  • Abnormal development of the central nervous system that can obstruct the flow of cerebral spinal fluid
  • Bleeding within the ventricles, a possible complication of premature birth
  • Infection in the uterus during a pregnancy, such as rubella or syphilis, that can cause inflammation in fetal brain tissues
  • Lesions or tumors of the brain or spinal cord
  • Central nervous system infections, such as bacterial meningitis or mumps
  • Bleeding in the brain from stroke or head injury
  • Other traumatic injury to the brain

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is hydrocephalus diagnosed?

If you suspect that you or your child has hydrocephalus, your doctor will perform a physical exam to look for signs and symptoms. In children, doctors check for eyes that are sunken in, slow reflexes, a bulging fontanel, and a head circumference that is larger than normal for their age.

Your doctor may also use an ultrasound to get a closer look at the brain. These tests use high-frequency sound waves to create images of the brain. This type of ultrasound can only be done in babies whose fontanel (soft spot) is still open.

Magnetic resonance imaging (MRI) scans can be used to look for signs of excess CSF. MRIs use a magnetic field and radio waves to make a cross-sectional image of the brain.

Computerized tomography (CT) scans can also help diagnose hydrocephalus in children and adults. CT scans use several different X-rays to form a cross-sectional image of the brain. These scans can show enlarged brain ventricles that result from too much CSF.

How is hydrocephalus treated?

Hydrocephalus can be fatal if it’s left untreated. Treatment may not reverse brain damage that’s already occurred. The goal is to prevent further brain damage. This involves restoring the normal flow of CSF. Your doctor may explore either of the following surgical options:

Shunt insertion

In most cases, a shunt is surgically inserted. The shunt is a drainage system made of a long tube with a valve. The valve helps CSF flow at a normal rate and in the right direction. Your doctor inserts one end of the tube in your brain and the other end into your chest or abdominal cavity. Excess fluid then drains from the brain and out the other end of the tube, where it can be more easily absorbed. A shunt implant is typically permanent and has to be monitored regularly.

Ventriculostomy

A procedure called a ventriculostomy can be performed as an alternative to having a shunt inserted. This involves making a hole at the bottom of a ventricle or in between ventricles. This allows CSF to leave the brain.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage hydrocephalus?

With the help of rehabilitative therapies and educational interventions, many people with hydrocephalus live with few limitations.

There are many resources available to provide emotional and medical support as you parent a child with hydrocephalus. Children with developmental problems due to hydrocephalus may be eligible for government-sponsored health care and other support services. Check with your state or county social services agency.

Hospitals and voluntary organizations serving people with disabilities are good resources for emotional and practical support, as are doctors and nurses. Ask these resources to help you connect with other families who are coping with hydrocephalus.

Adults living with hydrocephalus may find valuable information and support from organizations dedicated to hydrocephalus education and support, such as the Hydrocephalus Association.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 14, 2017 | Last Modified: September 11, 2019

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