At Banner Health, we understand that hearing the word hydrocephalus can be overwhelming. This condition happens when too much fluid called cerebrospinal fluid (CSF) builds up inside or around the brain. This extra fluid can cause problems like headaches, trouble walking or learning difficulties.
Hydrocephalus can happen to anyone, from babies to older adults. Some are born with it and others get it later. Knowing the different types can help you understand what it is and what treatments are available.
Hydrocephalus can happen for different reasons. Health care specialists often describe it based on when it happens and why. The two main types are congenital (present at birth) and acquired (develops later).
Congenital hydrocephalus, also called intrinsic or primary hydrocephalus, is a condition present at birth. It happens when something affects how the brain develops or how fluid drains from the brain, either before or shortly after birth.
This happens because of:
Hydrocephalus that happens after birth is called acquired, extrinsic or secondary hydrocephalus. Sometimes it happens suddenly and sometimes it develops slowly over time.
Possible causes include:
Hydrocephalus is diagnosed based on how the fluid inside the brain moves or doesn’t move. These details help guide treatment decisions.
In communicating hydrocephalus, CSF can still flow between the brain’s ventricles (open spaces in the brain). However, the body doesn’t absorb the fluid into the blood the way it should. The path is open but the fluid doesn't drain correctly. This makes the fluid build up and puts pressure on the brain.
This type is called communicating because the ventricles can still send signals to each other. It means the blockage is outside the ventricles, not inside.
In non-communicating hydrocephalus, something blocks the flow of CSF between parts of the brain called ventricles. This could happen because of a cyst, tumor, infection or a change in the brain's shape.
The blockage traps fluid behind it, causing the ventricles to expand and increasing pressure inside the brain. This type of hydrocephalus is usually fixed with surgery to remove the blockage or change where the fluid flows.
Normal pressure hydrocephalus, or NPH, mostly affects older adults. It's a kind of fluid problem in the brain called communicating hydrocephalus. Even though fluid builds up, the pressure inside the brain may look normal.
Over time, the ventricles stretch and press on nearby brain tissue. This can cause problems with walking, thinking and urination.
Since NPH can seem like other illnesses, like Parkinson’s or Alzheimer’s disease, it’s important to get an accurate diagnosis. With proper treatment, many people may get better, especially if they are diagnosed early.
You might hear the term ‘hydrocephalus ex vacuo’ but it’s important to know that this isn’t really hydrocephalus.
In this condition, the ventricles appear larger on brain scans but there is no increased pressure or fluid.
Our brains typically lose neurons over time which may be caused by normal aging or neurodegenerative conditions like Alzheimer’s disease, strokes or trauma. When this happens, CSF fills the areas within the brain where tissue has been lost making the ventricles appear larger.
Hydrocephalus ex vacuo doesn’t need the same treatment because it’s not caused by a problem with the flow of fluid in the brain. Instead, it shows that the brain has gotten smaller, not that there is a fluid imbalance.
Some people can have more than one kind of hydrocephalus or experience a mix of causes and flow patterns.
For example:
This shows that different kinds of hydrocephalus can sometimes occur at the same time. Because hydrocephalus can change over time or happen with other brain problems, getting the right diagnosis and ongoing follow-up are very important.
If your health care provider thinks you might have hydrocephalus, they will do some tests. These tests check for enlarged ventricles and fluid buildup in your brain. The tests can include:
Your provider might also perform neurological exams to check vision, balance, coordination and mental function. For adults, more tests can help find out if the symptoms are caused by hydrocephalus or something else.
Learn more about diagnosing hydrocephalus.
The main goal of treatment is to fix the flow of CSF and reduce pressure in the brain. Surgery is the most common way to treat this. There are two main types of surgery:
Your surgeon will suggest the best treatment for you based on your age, overall health and what caused the hydrocephalus. After surgery, regular check-ups are important to make sure the shunt or ETV works well.
Learn more about treating hydrocephalus.
Most people with hydrocephalus can live full, active lives if they get treatment early. Children often grow and develop normally with care and therapy. Adults can regain balance and confidence after surgery.
With adequate treatment, elderly adults with normal pressure hydrocephalus may experience improvement in their balance, allowing them to walk confidently and prevent falls.
Some people need physical, occupational and speech therapy to help with ongoing symptoms. Support groups, patient education and regular check-ups also help improve their quality of life.
Banner Health provides expert diagnostic testing, advanced surgical options and caring support for patients and their families. Our teams include neurologists, neurosurgeons and rehabilitation experts. They work together to help you or someone you love manage hydrocephalus now and in the future.
If you or a loved one is experiencing symptoms or needs guidance about treatment, our neuroscience team is here to help. Find a Banner Health specialist near you.
Sign in to Patient Account
