Hydrocephalus

Hydrocephalus is a condition in which too much fluid builds up in the brain. The fluid collects in cavities called ventricles. The fluid is cerebrospinal fluid (CSF). CSF is a clear liquid that normally surrounds both the spinal cord and the brain.
Hydrocephalus occurs when:
  • Too much CSF is produced
  • There is a blockage that doesn't allow CSF to drain properly
Hydrocephalus can be: Congenital - you are born with it Acquired - you suffer an injury or an illness that causes it to develop

Causes

Causes include:
  • Brain tumors
  • Cysts in the brain
  • Malformations of the brain, such as:
    • Dandy-Walker syndrome
    • Arnold-Chiari malformation
    • Spina bifida
  • Brain injuries
  • Infections
    • Encephalitis
    • Meningitis
    • Toxoplasmosis
    • Cytomegalovirus
  • Blood vessel abnormalities in the brain
  • Bleeding into the brain

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Neural tube defects
  • Mother has infection during pregnancy
  • Brain infections
  • Malformations of the brain
  • Brain injuries

Symptoms

Symptoms of Hydrocephalus depend on the area of the brain affected and the severity of the Hydrocephalus. Symptoms may start out mild and become more severe as more CSF accumulates. The CSF puts pressure on structures within the brain, causing symptoms.
Symptoms may include:
  • Headache
  • Vomiting
  • Problems with balance
  • Difficulty walking
  • Poor coordination
  • Incontinence
  • Personality changes
  • Confusion
  • Memory problems
  • Dementia in the elderly
  • In babies:
    • Slow development
    • Loss of developmental milestones
    • Bulging fontanelle (soft spot on the head)
    • Large head circumference

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include:
  • CT Scan – a type of x-ray that uses a computer to make pictures of the inside of the brain
  • MRI Scan – a test that uses magnetic waves to make pictures of the inside of the brain
  • Ultrasound – a test that uses sound waves to examine the brain

Treatment

Treatment may include:
Shunt Placement (Ventriculoperitoneal Shunt) – this is a surgical procedure. A shunt is a tube system that is implanted into the brain. The shunt allows excess CSF to drain into another area, usually the abdomen.
Third Ventriculostomy- this surgical procedure creates a hole in an area of the brain. It allows the CSF to flow out of the area where it is accumulating.
Lumbar Puncture (Spinal Tap) - the insertion of a needle between the lumbar vertebrae in the back to remove excess CSF.
Medications - in some cases, medications (acetazolamide and furosemide) may decrease the production of CSF.

Prevention

There are no known ways to prevent Hydrocephalus. People who have risk factors for Hydrocephalus should be carefully monitored. Immediate treatment might prevent long-term complications.