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 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.