Hydrocephalus

Overview

Hydrocephalus (“water on the brain”) is a rare condition that happens when too much cerebrospinal fluid (CSF) collects in open spaces in the brain called ventricles. CSF usually supports and cushions your brain. Too much fluid creates pressure and causes symptoms that can lead to permanent brain damage and developmental impacts. Without treatment, it can be fatal. But most cases are treatable, and many are curable.

You can be born with hydrocephalus (congenital) or develop it after an injury or illness (acquired). There are four types of hydrocephalus:

• Communicating hydrocephalus—the collection of extra CSF happens without an obvious blockage in the brain.
• Hydrocephalus ex-vacuo—CSF buildup after a stroke, traumatic brain injury or degenerative disease of the brain.
• Normal pressure hydrocephalus (NPH)—this version develops slowly and is common in people over 60. The first sign is a fall without losing consciousness. It also causes memory issues, urinary incontinence and difficulty walking.
• Obstructive hydrocephalus—CSF buildup caused by a brain tumor, Chiari malformation or previous brain hemorrhage.

Risk Factors & Symptoms

Hydrocephalus can happen at any age. As an adult, some of your risk factors include:

• Bleeding in the brain
• Brain infections like meningitis
• Brain surgery
• Central nervous system tumors
• Head trauma

Seek medical attention quickly if you experience any of these symptoms:

• Balance or coordination problems
• Bladder control problems
• Changes in walking pattern
• Difficulty waking or staying awake
• Headache
• Impaired vision or cognitive skills
• Memory loss

Diagnosing Hydrocephalus

Left untreated, hydrocephalus symptoms worsen over time. But with an accurate diagnosis, it’s possible to reverse the impact on your brain and body. To identify hydrocephalus, your doctor may recommend one or more of these tests:

• CT scan of your brain and the blood vessels in your head
• Intracranial pressure (ICP) monitoring to determine if CSF pressure is causing your symptoms
• Lumbar puncture to collect and evaluate the fluid around your brain and spinal cord
• MRI to examine the structures in your head
• Neuropsychological assessment to evaluate your cognitive functioning

Hydrocephalus Treatment

We offer comprehensive hydrocephalus treatment to reduce the extra CSF fluid and pressure on your brain. Based on your symptoms and unique needs, we may recommend either of these surgical options:

Shunt

This surgically inserted drainage system uses a small tube (catheter) to help CSF fluid flow in the right direction and at a normal rate. People typically experience improved symptoms within a few hours after the one-hour procedure.

Ventriculostomy

With this procedure, your surgeon creates a temporary small hole in your skull and uses a catheter, drainage bag and monitor to remove extra CSF from your head. This treatment is an option when you don’t need a long-term shunt.