Hydrocephalus

What Is Hydrocephalus?

Hydrocephalus is a medical condition that occurs when there is an abnormal accumulation of cerebrospinal fluid (CSF) in the brain. CSF is a clear, watery fluid that surrounds and protects the brain and spinal cord, and it is produced by the choroid plexus, a network of blood vessels in the brain. In a normal brain, the CSF is continuously produced and then absorbed into the bloodstream. In a brain with hydrocephalus, the flow of CSF is blocked or slowed, and the excess fluid can cause the ventricles (cavities) in the brain to become enlarged, which can lead to an increase in intracranial pressure (pressure inside the skull).

Hydrocephalus can occur at any age, and it can be caused by a variety of factors, including brain abnormalities, infections, and injuries. The most common symptoms of hydrocephalus in infants and young children include an unusually large head, difficulty with balance and coordination, and developmental delays. In adults, symptoms may include headache, nausea and vomiting, difficulty with balance, and difficulty with thinking and memory. Treatment for hydrocephalus usually involves the placement of a ventriculoperitoneal shunt, which is a small device that is used to drain the excess CSF from the brain and redirect it to another area of the body, such as the abdomen.

What Is the Cause of Hydrocephalus?

Hydrocephalus results from cranial surgery, a hemorrhage, a tumor, head injury or meningitis, or it can be idiopathic. However, the cause of most hydrocephalus cases is largely unknown.

What Are the Risk Factors For Hydrocephalus?

Some conditions that could increase the risk for hydrocephalus include:

• Nervous system infections
• Severe head injuries
• Bleeding in the brain
• Lesions or tumors in the spinal cord or brain
• Arachnoid cyst. An arachnoid cyst is a fluid-filled sac that develops within the brain or spinal cord. These cysts are typically benign (noncancerous) and do not usually cause symptoms. However, in rare cases where an arachnoid cyst becomes large enough or is in a sensitive location, it can press on nearby brain tissue or nerves, leading to symptoms such as headache, seizures, weakness, numbness, and changes in vision or hearing, among others. Treatment for arachnoid cysts typically depends on the size and location of the cyst and the severity of the symptoms. In some cases, surgery may be necessary to remove the cyst or to relieve pressure on the brain. In other cases, cysts are incidental (not causing symptoms), and for others, medications or other treatments may be used to manage symptoms.

Be sure to talk with your doctor if you have any questions or concerns about these risk factors.

What Are the Types of Hydrocephalus?

There are three different types of hydrocephalus:

• Obstructive
• Normal pressure hydrocephalus
• Idiopathic intracranial hypertension

Hydrocephalus can also be communicating or non-communicating. In communicating hydrocephalus, the cerebrospinal fluid is not reabsorbed normally or there is increase in production of cerebrospinal fluid that can lead to increase in the size of the ventricles. However, the fluid can still flow through.

Non-communicating hydrocephalus, sometimes referred to as obstructive hydrocephalus, happens when the flow of cerebrospinal fluid is blocked in one or more of the passages that connect the ventricles.

Sometimes the cause is unknown, and you can have idiopathic intracranial hypertension with normal or small ventricles and increased intracranial pressure.

What Are the Symptoms of Hydrocephalus?

The symptoms can vary, but common symptoms of hydrocephalus include:

• Lethargy
• Impaired vision
• Headache
• Loss of bladder control
• Loss of balance
• Decline in memory, concentration or other skills that may affect job performance
• Memory loss
• Difficulty walking, often described as shuffling
• Poor coordination
• Loss of thinking or other reasoning skills

Hydrocephalus Treatment and Support

Currently, there is no known cure or prevention method for hydrocephalus. Early detection and treatment of hydrocephalus can help patients lead full and active lives.  After diagnosis, there are surgical options for treatment. Surgical hydrocephalus treatments include:

Shunt system

A shunt system is the most common hydrocephalus treatment. For this treatment, a shunt (flexible tube) is placed into the brain’s ventricular system. This shunt helps maintain cerebrospinal fluid at normal levels and redirects the flow of cerebrospinal fluid to another region of the body where it can be absorbed.

Ventriculoperitoneal shunt

A ventriculoperitoneal (VP) shunt is a medical device that is used to treat hydrocephalus, a condition in which there is too much cerebrospinal fluid (CSF) in the brain. The VP shunt is a tube that is inserted into the brain through a small hole in the skull and it is used to drain excess CSF from the brain and redirect it to another part of the body, such as the abdomen.

VP shunts are typically used to treat hydrocephalus that is caused by a blockage in the flow of CSF, such as a tumor or an infection. They are also used to treat hydrocephalus that is present at birth (congenital hydrocephalus). VP shunts are usually placed in the brain during a surgical procedure, and they are typically inserted by a neurosurgeon.

VP shunts are a safe and effective treatment option for many patients with hydrocephalus and they can significantly improve the symptoms of the condition. However, like any medical device, VP shunts can malfunction or become infected and they may need to be removed or replaced. It is important for patients with VP shunts to follow their healthcare provider's instructions and to report any changes in their symptoms to their provider. 

Learn more about the types of aneurysms, risk factors, symptoms and treatment options from Banner Brain & Spine.

Endoscopic third ventriculostomy (ETV)

An ETV uses an endoscope to puncture a membrane in the brain’s third ventricle to allow fluid to flow. This procedure is a good alternative to shunting, especially for those with obstructive hydrocephalus.

If you or a family member is diagnosed with hydrocephalus, know that the expert medical staff at   Banner Brain & Spine are here to help at every stage.