What is hydrocephalus?

Hydrocephalus is the medical term for the accumulation of fluids in the brain, sometimes called “water on the brain.” This excess of cerebrospinal fluid (CSF) causes the spaces in the brain (ventricles) to grow. This can lead to harmful pressure on brain tissues and can be related to active hydrocephalus.

CSF generally flows through the ventricles and coats the brain and spinal column. When hydrocephalus causes pressure on the brain, it can impair brain function.

There are several types of hydrocephalus:

• Nonobstructive. This occurs when CSF flows out of the brain chambers and into the spinal canal. The fluid isn't reabsorbed into the veins and tissue around the brain and spinal cord. This form is also called "communicating hydrocephalus" and can sometimes correct itself.
• Obstructive. This occurs when the CSF doesn't have proper flow because of an obstacle, like a narrowing or deformity. This form is also called "noncommunicating hydrocephalus."
• Congenital hydrocephalus. Present at birth, this type forms when the baby is still developing in the womb and is usually diagnosed during routine ultrasounds during pregnancy.
• Acquired hydrocephalus. This type forms after birth as a result of head trauma, a brain tumor, bleeding or infections.

No matter the type, early detection is key to effective treatment of any form of hydrocephalus.

What are the signs and symptoms of hydrocephalus?

While the exact cause of hydrocephalus is unknown, the signs and symptoms can be the same regardless of how it formed.

If your child is suffering from hydrocephalus, his or her head’s size may grow suddenly. Common hydrocephalus symptoms include:


• Blurred or double vision
• Developmental delays 
• Headaches
• Irritability 
• Nausea
• Poor coordination or balance
• Seizures 
• Sleepiness 
• Vomiting 
• Downward gaze 
• Bulging fontanelle (baby’s soft spot)
• Sudden growth in your child’s head

Diagnosing hydrocephalus 

Hydrocephalus can sometimes be diagnosed during pregnancy through an ultrasound. However, after birth, it can be diagnosed using tests that include:

• Physical exam: A doctor will conduct a series of tests on your child's muscles, movement and functioning.
• Magnetic resonance imagining (MRI): MRIs use powerful radio waves and magnets to create detailed, 3D images of the brain.
• Computerized tomography (CT or CAT) scans: CT scans use X-rays to obtain cross-sectional images of the brain.
• Ultrasound: Ultrasound imaging uses high-frequency sound waves to produce images.
• Spinal tap: A spinal tap allows the doctor to remove fluid from the spine to help make a diagnosis.

These tests are necessary to help your child receive the most appropriate treatment, and we want to make sure you fully understand your child’s treatment plan. We know tests like these can be scary for both you and your little one, which is why we’re here to help you through every step of the process.

How is hydrocephalus treated?

A common treatment for hydrocephalus is surgery in which a drainage system, called a shunt — a narrow tube — is inserted into the area of the brain where the fluid is gathering. This tube allows the fluid to drain to another part of the body.

Another common treatment for hydrocephalus is an endoscopic third ventriculostomy, which creates a bypass for the cerebrospinal fluid. Children who undergo this surgery will not have a shunt.

Further hydrocephalus treatment is sometimes needed after surgery. Common treatment options after hydrocephalus surgery can include occupational therapy and developmental therapy. Our pediatric neurosurgery team will work to identify the best treatment course for your child.