Learn about this potentially fatal condition that causes fluid buildup in the brain. It can cause a range of symptoms, from headaches to poor balance.
Hydrocephalus is the buildup of fluid in cavities called ventricles deep within the brain. The excess fluid increases the size of the ventricles and puts pressure on the brain.
Cerebrospinal fluid usually flows through the ventricles and bathes the brain and spinal column. But the pressure of too much cerebrospinal fluid can damage brain tissues and cause a range of symptoms related to brain function.
Hydrocephalus can happen at any age, but it occurs more often among infants and among adults 60 and older. Surgery can restore and maintain healthy cerebrospinal fluid levels in the brain. Therapies can manage symptoms resulting from hydrocephalus.
The symptoms of hydrocephalus can vary by age.
Common symptoms of hydrocephalus in infants include:
Among toddlers and older children, symptoms might include:
Common symptoms in this age group include:
Among adults 60 and older, the more common symptoms of hydrocephalus are:
Seek emergency medical care for infants and toddlers with these symptoms:
Seek prompt medical attention for other hydrocephalus symptoms in any age group.
More than one condition can cause the problems associated with hydrocephalus. 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.
Tissues lining the ventricles of the brain produce cerebrospinal fluid. It flows through the ventricles by way of 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 can occur 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.
Much of the time, the cause of hydrocephalus is not known. However, developmental or medical problems can contribute to or trigger hydrocephalus.
Hydrocephalus may be present at or before birth, known as congenital hydrocephalus. Or it can occur shortly after birth. Any of the following incidents may cause hydrocephalus in newborns:
Other factors that can contribute to hydrocephalus among any age group include:
In most cases, hydrocephalus worsens. Without treatment, hydrocephalus leads to complications. Complications may include learning disabilities or developmental and physical disabilities. Complications of this condition also can result in death. When hydrocephalus is mild and it's treated, there may be few, if any, serious complications.
A diagnosis of hydrocephalus is usually based on:
The type of neurological exam depends on a person's age. A health care professional might ask questions and conduct simple tests to judge muscle condition, movement, well-being and function of sensory abilities.
Imaging tests can help diagnose hydrocephalus. They also can pinpoint underlying causes of symptoms. Imaging tests 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. MRI also can be used to find causes of hydrocephalus or other conditions contributing to symptoms.
Children might need medicine to help them feel calm, known as mild sedation, for some MRI scans. However, some hospitals use a fast version of MRI that usually 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 scans show less detail than do MRI scans. And CT technology causes exposure to a small amount of radiation. CT scans for hydrocephalus usually are 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 stomach or a heart chamber. This allows excess fluid to be more easily absorbed.
People who have hydrocephalus usually need a shunt system for the rest of their lives. They require regular monitoring.
Some people may have a surgery called endoscopic third ventriculostomy. The surgeon uses a small video camera to see inside the brain. Then the surgeon makes a hole in the bottom of a ventricle. This allows cerebrospinal fluid to flow out of the brain.
Both surgical procedures can result in complications. Shunt systems can stop draining cerebrospinal fluid. Or shunt systems may poorly regulate drainage because of mechanical problems, a blockage or infections. Complications of ventriculostomy include bleeding and infections.
Complications of surgery require prompt attention. Another surgery or other interventions may be needed. Fever or symptoms of hydrocephalus should prompt an appointment with your health care professional.
Some people with hydrocephalus, particularly children, might need supportive therapies. Need for these therapies depends on the long-term complications of hydrocephalus.
Children's care teams might include:
Children who are in school may need special education. Special education teachers address learning disabilities, determine educational needs and help find needed resources.
Adults with more serious complications might need the services of occupational therapists or social workers. Or they may need to see 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 stomach, where it can be more easily absorbed.
With the help of therapies and educational services, many people with hydrocephalus live with few limitations.
If you have a child with hydrocephalus, there are many resources available to provide emotional and medical support. Children with developmental disabilities 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. Members of your health care team also can help. Ask for help connecting with other families who are coping with hydrocephalus.
Adults living with hydrocephalus might find valuable information from organizations dedicated to hydrocephalus education and support, such as the Hydrocephalus Association.
Ask your child's or your health care team 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 also is 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 bad the symptoms are and when problems appeared. It also may depend on whether there were risk factors for hydrocephalus during the pregnancy or delivery. Sometimes hydrocephalus can be diagnosed at birth or before birth.
It's important to take your child to all regularly scheduled well-baby visits. Health care professionals monitor your child's development in key areas, including:
Questions you should be prepared to answer during regular checkups might include:
You'll likely start by seeing your child's or your health care professional. You may then be referred to a doctor who specializes in brain and nervous system conditions, known as a neurologist.
Be prepared to answer the following questions about your symptoms or on your child's behalf: