Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Hydrocephalusis the buildup ofcerebrospinal fluid (CSF)within the brain’s hollow spaces (ventricles). 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.
This article reviews key facts about hydrocephalus, including its types, symptoms, causes, diagnosis, treatment, and outlook.
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Types of Hydrocephalus
Hydrocephalus can occur at any age but is most common in babies and older adults. The two main types are:
Hydrocephalus is also sometimes categorized as congenital or acquired hydrocephalus.Congenital hydrocephalusis present at birth, whereasacquired hydrocephalusdevelops after birth.
The following two forms of acquired hydrocephalus can develop in adults:
Hydrocephalus Symptoms
Hydrocephalus symptoms often occur due to increased pressure within the skull (increasedintracranial pressure).
In congenital hydrocephalus, symptoms may include:
In older children and adults, hydrocephalus symptoms include:
There are also symptoms specific to the type of hydrocephalus, especially regarding normal pressure hydrocephalus.
The three hallmark symptoms of NPH include:
Hydrocephalus has many potential causes, depending on the type.
Other causes of hydrocephalus in babies include:
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.
Imaging Tests
The type of imaging test used to evaluate hydrocephalus depends on the age of the patient:
MRI: Preferred Diagnostic Test for HydrocephalusAn MRI is often the preferred test for diagnosing hydrocephalus. Using magnetic fields and radio waves, an MRI can help assess CSF flow and reveal whether the ventricles are enlarged.
MRI: Preferred Diagnostic Test for Hydrocephalus
An MRI is often the preferred test for diagnosing hydrocephalus. Using magnetic fields and radio waves, an MRI can help assess CSF flow and reveal whether the ventricles are enlarged.
Spinal Tap
Aspinal tap(lumbar puncture) is performed in a healthcare provider’s office or a hospital. A thin needle is placed into the person’s lower back. The pressure of the CSF is measured, and then up to 50 cubic centimeters (cc) of CSF is removed for analysis.
Spinal taps can also be therapeutic because they often temporarily relieve a person’s hydrocephalus symptoms.
Intracranial Pressure Monitoring
In some cases, such as after severe head trauma,intracranial pressure(ICP) monitoring may be used to detect and measure CSF pressure.
If the pressure gets too high, the CSF may need to be drained to ensure adequate oxygenation to the brain.
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.
Ommaya Reservoir
Shunt Surgery
The most common surgery for hydrocephalus involves placing a shunt (a thin, hollow tube) to reroute the extra CSF away from the brain, lowering the pressure within the skull.
Duringshunt surgery, a neurosurgeon places the shunt through an opening in the skull into the ventricle. The shunt tubing is then passed under the skin into another area of the body (usually the abdominal cavity), where the CSF drains.
Are Shunts Permanent?Shunts often remain in place for the duration of a person’s life, but that is not always necessary. 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.
Are Shunts Permanent?
Shunts often remain in place for the duration of a person’s life, but that is not always necessary. 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.
During this surgery, an endoscope (a long, thin device attached to a tiny camera) and special surgical tools inserted through the endoscope are used to make a small hole in the brain’s third ventricle. This hole creates a pathway for the excess CSF to flow in and around the brain.
The outlook for those living with hydrocephalus depends on factors like the hydrocephalus cause, severity, type of symptoms, and promptness of treatment.
As an example, after shunt placement, adults with normal pressure hydrocephalus may notice an improvement in their cognitive (thinking and memory) skills, walking, and bladder problems within days after surgery.
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. Generally speaking, though, the sooner hydrocephalus is diagnosed and treated, the better the chances for a successful outcome.
Ongoing Care for Children With HydrocephalusChildren with hydrocephalus may experience delays in reaching milestones like sitting, crawling, standing, walking, and talking. Early rehabilitation therapy can help children improve, adapt, and cope with development or physical impairments.
Ongoing Care for Children With Hydrocephalus
Children with hydrocephalus may experience delays in reaching milestones like sitting, crawling, standing, walking, and talking. 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.
If you or a loved one are being treated for hydrocephalus, consider seeking support from an organization likeHydrocephalus Association. Support resources, whether a helpline, community network, or pen pal program for children, can be a tremendous source of comfort and emotional guidance.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Neurological Disorders and Stroke.Hydrocephalus fact sheet.
American Association of Neurological Surgeons.Adult-onset hydrocephalus.
National Organization of Rare Diseases.Hydrocephalus.
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