Read more about this potentially fatal disorder that causes fluid buildup in the brain — resulting in a range of symptoms, from headaches to poor balance.
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 range of brain function problems.
Hydrocephalus can happen at any age, but it occurs more frequently among infants and adults 60 and over. Surgical treatment for hydrocephalus can restore and maintain normal cerebrospinal fluid levels in the brain. Different therapies are often required to manage symptoms or problems resulting from hydrocephalus.
The signs and symptoms of hydrocephalus vary somewhat by age of onset.
Common signs and symptoms of hydrocephalus in infants include:
Among toddlers and older children, signs and symptoms might include:
Common signs and symptoms in this age group include:
Among adults 60 years of age and older, the more common signs and symptoms of hydrocephalus are:
Seek emergency medical care for infants and toddlers with these signs and symptoms:
Seek prompt medical attention for other signs or symptoms in any age group.
More than one condition can cause the problems associated with hydrocephalus, so it's important to get a timely diagnosis and appropriate care.
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. The fluid eventually flows into spaces around the brain and spinal column. It's absorbed primarily by blood vessels in tissues on the surface of the brain.
Cerebrospinal fluid plays an important role in brain function by:
Too much cerebrospinal fluid in the ventricles occurs for one of the following reasons:
Your brain floats in a bath of cerebrospinal fluid. This fluid also fills large open structures, called ventricles, which lie deep inside your brain. The fluid-filled ventricles help keep the brain buoyant and cushioned.
In many cases, the cause of hydrocephalus is unknown. However, a number of developmental or medical problems can contribute to or trigger hydrocephalus.
Hydrocephalus present at birth (congenital) or shortly after birth can occur because of any of the following:
Other factors that can contribute to hydrocephalus among any age group include:
In most cases, hydrocephalus progresses, which means complications, including intellectual, developmental and physical disabilities, can occur if it's not treated. It can also be life-threatening. Less severe cases, when treated appropriately, might have few, if any, serious complications.
A diagnosis of hydrocephalus is usually based on:
The type of neurological exam will depend on a person's age. The neurologist might ask questions and conduct relatively simple tests in the office to judge muscle condition, movement, well-being and how well the senses are functioning.
Imaging tests that can help diagnose hydrocephalus and identify underlying causes of the symptoms include:
MRI. This test uses radio waves and a magnetic field to produce detailed images of the brain. This test is painless, but it is noisy and requires lying still.
MRI scans can show enlarged ventricles caused by excess cerebrospinal fluid. They can also be used to identify causes of hydrocephalus or other conditions contributing to the symptoms.
Children might need mild sedation for some MRI scans. However, some hospitals use a fast version of MRI that generally doesn't require sedation.
CT scan. This specialized X-ray technology produces cross-sectional views of the brain. Scanning is painless and quick. But this test also requires lying still, so a child usually receives a mild sedative.
CT scanning produces less detailed images than MRI does and causes exposure to a small amount of radiation. CT scans for hydrocephalus are usually used only for emergency exams.
One of two surgical treatments can be used to treat hydrocephalus.
The most common treatment for hydrocephalus is the surgical insertion of a drainage system, called a shunt. It consists of a long, flexible tube with a valve that keeps fluid from the brain flowing in the right direction and at the proper rate.
One end of the tubing is usually placed in one of the brain's ventricles. The tubing is then tunneled under the skin to another part of the body — such as the abdomen or a heart chamber — where the excess fluid can be more easily absorbed.
People who have hydrocephalus usually need a shunt system for the rest of their lives. They require regular monitoring.
Endoscopic third ventriculostomy is a surgical procedure that can be used for some people. The surgeon uses a small video camera see inside the brain. Your surgeon makes a hole in the bottom of one of the ventricles or between the ventricles to enable cerebrospinal fluid to flow out of the brain.
Both surgical procedures can result in complications. Shunt systems can stop draining cerebrospinal fluid or poorly regulate drainage because of mechanical problems, blockage or infections. Complications of ventriculostomy include bleeding and infections.
Any failure requires prompt attention, surgical revisions or other interventions. Fever or recurrence of the original symptoms of hydrocephalus should prompt an appointment with your doctor.
Some people with hydrocephalus, particularly children, might need additional treatment, depending on the severity of long-term complications of hydrocephalus.
Children's care teams might include the following:
Children who are in school will likely need special education teachers, who address learning disabilities, determine educational needs and identify needed resources.
Adults with more-severe complications also might need the services of occupational therapists, social workers, specialists in dementia care or other medical specialists.
A shunt drains excess cerebrospinal fluid from the brain to another part of the body, such as the abdomen, where it can be more easily absorbed.
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 might be eligible for government-sponsored health care and other support services. Check with your state or county social services agency.
Hospitals and organizations serving people with disabilities are good resources for emotional and practical support, as are doctors and nurses. Ask for help connecting with other families who are coping with hydrocephalus.
Adults living with hydrocephalus might find valuable information and support from organizations dedicated to hydrocephalus education and support, such as the Hydrocephalus Association.
Ask your doctor if you or your child should receive a vaccine against meningitis, once a common cause of hydrocephalus. The Centers for Disease Control and Prevention recommends meningitis vaccination for preteen children and boosters for teenagers. Vaccination is also recommended for younger children and adults who might be at increased risk of meningitis for any of the following reasons:
The timing of diagnosing a child with hydrocephalus can depend on how severe the symptoms are, when problems appear, and whether there were major risk factors for hydrocephalus during the pregnancy or delivery. In some cases, hydrocephalus can be diagnosed at birth or before birth.
It's important to take your child to all regularly scheduled well-baby visits. Your child's doctor will monitor your child's development in key areas, including:
Questions you should be prepared to answer during regular checkups might include the following:
If you're seeing a doctor because of the recent onset of symptoms, you'll likely start by seeing your primary care doctor or your child's pediatrician. After an initial evaluation, your doctor might refer you to a doctor who specializes in the diagnosis and treatment of conditions that affect the brain and nervous system (neurologist).
Be prepared to answer the following questions about your symptoms or on your child's behalf: