Hydrocephalus
Cerebrospinal fluid normally circulates sequentially through the four ventricles of the brain and then passes into the large veins on top of the brain where it is reabsorbed. Hydrocephalus occurs when there is too much cerebrospinal fluid (CSF) within the ventricles, resulting in excess pressure in the brain. A child can be born with hydrocephalus (congenital) or develop the condition during or after birth (acquired).
The brain constantly makes cerebrospinal fluid. CSF is normally absorbed into the blood and carried out of the brain as new CSF is made. In hydrocephalus, the CSF continues to build up in the brain and can cause brain injury.
The Margaret Hackett Family Program
At UChicago Medicine, our dedicated neurosurgeons are here to help. For more information about hydrocephalus and the resources we have available, please call the Margaret Hackett Family Program (MHFP) at 773-795-0622.
What Is Hydrocephalus?
Hydrocephalus occurs when there is too much cerebrospinal fluid (CSF) within the ventricles of the brain, resulting in excess pressure in the brain.
How it works:
- The brain constantly makes cerebrospinal fluid.
- Cerebrospinal fluid normally circulates sequentially through the four ventricles of the brain and then passes into the large veins on top of the brain where it is reabsorbed.
- CSF is normally absorbed into the blood and carried out of the brain as new CSF is made.
- In hydrocephalus, the CSF continues to build up in the brain and can cause brain injury.
A child can be born with hydrocephalus (congenital) or develop the condition during or after birth (acquired).
Types of Hydrocephalus
Hydrocephalus is not one single condition — it is a term that covers several different situations, each with its own cause and its own approach to treatment. Knowing which type applies to you or your child helps the care team choose the most effective path forward. Types of hydrocephalus include:
- Congenital hydrocephalus
- Acquired hydrocephalus
- Obstructive hydrocephalus
- Absorptive hydrocephalus
- Normal pressure hydrocephalus (NPH)
Symptoms of Hydrocephalus
Signs and symptoms of hydrocephalus vary depending on a patient’s age and other underlying conditions.
- Bulging of soft spot on a baby’s head (fontanelle)
- Downward-gazing eyes
- Irritability
- Rapid increase of head circumference
- Seizures
- Sleepiness
- Vomiting
- Balance changes
- Blurred or double vision
- Clumsiness
- Downward-gazing eyes
- Headache
- Incontinence
- Nausea and vomiting
- Personality changes
- Sleepiness and irritability
Causes of Hydrocephalus
The most common cause of congenital hydrocephalus is a blockage between two ventricles that prevents CSF from moving through the brain.
Many other types of brain development problems can cause hydrocephalus such as:
- Brain cysts
- Genetic disorders
- Infections during pregnancy
- Spinal cord abnormalities
Risk factors of developing congenital hydrocephalus include:
- Diabetes present during pregnancy
- Family history of congenital hydrocephalus
- Poor prenatal care during pregnancy
Acquired hydrocephalus is caused by injuries or conditions that develop after birth, such as:
- Bleeding in the brain
- Brain infections (meningitis)
- Brain tumors
- Head injury
Diagnosis and Treatment of Hydrocephalus
Hydrocephalus is diagnosed with a physical exam, medical history and brain imaging tests including an MRI or CT scan. Congenital hydrocephalus can be diagnosed before birth using a fetal ultrasound during pregnancy.
Surgery is the only treatment for hydrocephalus. The most common type of surgery is the placement of a flexible tube (shunt) in the brain or spinal cord to drain the fluid into another part of the body. The shunt may need to be adjusted or replaced over time as your child grows.
Normal Pressure Hydrocephalus (NPH) in Adults
Late onset hydrocephalus in adults or normal pressure hydrocephalus (NPH) occurs when patients cannot tolerate brain pressures considered “normal” as they age. NPH is associated with aging or certain medical conditions.
NPH may be caused by anything that blocks the flow of CSF such as:
- Bleeding from a blood vessel in the brain
- Brain surgery
- Head injury
- Infections
- Tumors or cancer
- Difficulty walking, such as shuffling feet when walking, unsteadiness or feet feeling as though they are stuck to the floor
- Problems with bowl or bladder control
- Memory problems, such as confusion, forgetfulness, lack of concentration or mood changes
Diagnosis is based on the following:
- Medical history
- Physical exam
- Diagnostic testing
NPH may be treated with surgery to place a narrow tube (ventriculoperitoneal shunt or VP shunt) in the brain to drain excess CSF. After the placement of the shunt you will be monitored to ensure CSF is draining properly.
Request an Appointment
We are currently experiencing a high volume of inquiries, leading to delayed response times. For faster assistance, please call 1-773-702-2123 to schedule your appointment.
If you have symptoms of an urgent nature, please call your doctor or go to the emergency room immediately.
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