Hydrocephalus  

Hydrocephalus is a build up of cerebrospinal fluid deep within the brain.  

Known simply by some as “water in the brain,” hydrocephalus is characterized by an abnormal amount of cerebrospinal fluid (CSF) in the brain’s deep-seeded cavities, or ventricles. This build-up of fluid can lead to pressure in the brain and a wide range of symptoms. If left untreated, hydrocephalus may be fatal.  

There are two types of hydrocephalus that affect children:  

• Congenital hydrocephalus – Hydrocephalus that is present at birth  
• Acquired hydrocephalus – Hydrocephalus that develops after birth  

Hydrocephalus Causes    

Cerebrospinal fluid is an important substance that helps feed the brain and promote a healthy nervous system. While CSF is normally absorbed into blood vessels, hydrocephalus occurs when this absorption process is disrupted by one of the following:  

• Obstruction from a blocked or narrowed ventricle  
• Overproduction of CSF  
• Poor filtration due to brain inflammation, injury or disease 

Hydrocephalus Symptoms   

Damage in the brain caused by hydrocephalus can lead to a variety of symptoms that vary by type. For example, acquired hydrocephalus that develops after birth may cause:   

• Blurred or double vision  
• Headaches 
• Trouble walking  
• Neck pain 
• Seizures 
• Excessive sleepiness  
• Confusion or disorientation  
• Irritability  
• Loss of appetite  
• Nausea or vomiting  
• Urinary incontinence  

Possible signs and symptoms of congenital hydrocephalus, which is present at birth, include:  

• Difficulty breathing  
• An unusually large head  
• A delay in milestones, such crawling or sitting up  
• Trouble feeding   
• Stiff arm or leg muscles that may contract frequently   
• A bulging “soft spot” (fontanel) on the head  
• A reluctance to lay down or move the head or neck  
• Thin skin on the scalp with visible veins  
• Eyes that tend to look downward  
• An unusually high-pitched cry  

Hydrocephalus Diagnosis  

Congenital hydrocephalus can be identified in utero when the mother receives an ultrasound. Following childbirth, a baby may undergo a brain scan if his or her head measures too large or other symptoms are noticed.   

If a physician suspects a child may have acquired hydrocephalus, a combination of neurological examinations and brain scans may be performed to confirm a diagnosis.  

Hydrocephalus Treatments  

The Muma Children's Hospital at TGH includes specialists in pediatrics, neonatology, neurosurgery and other disciplines, allowing young patients to experience a full spectrum of care in a single location. The most common treatment approach for hydrocephalus is shunt surgery, which involves inserting a small drainage system into the brain to remove excess fluid. Another option is an endoscopic third ventriculostomy (ETV), a surgery that drains built-up fluid by creating a small hole in the brain’s surface.