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
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
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
- Trouble walking
- Neck pain
- Excessive sleepiness
- Confusion or disorientation
- 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
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.
The Children’s Institute at Tampa General Hospital 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.