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What is Hydrocephalus ?

Hydrocephalus is an excessive accumulation of cerebrospinal fluid (CSF) in the ventricular spaces of the brain. It's most common in neonates but can also occur in adults as a result of injury or disease. In infants hydrocephalus enlarges the head; in both infants and, adults, resulting compression can damage brain tissue. With early detection and surgical intervention, the prognosis improves but remains guarded.

Causes of Hydrocephalus

Hydrocephalus results from an obstruction in CSF flow (non communicating hydrocephalus) or from faulty absorption of CSF (communicating hydrocephalus).

In non communicating hydrocephalus, the obstruction occurs most frequently between the third and fourth ventricles and at the aqueduct of Sylvius. It can also occur at the outlets of the fourth ventricle (foramina of Luschka and Magendie) or, rarely, at the foramen of Monro. This obstruction may result from faulty fetal development (myelomeningocele, congenital arachnoid cysts), infection (syphilis, granulomatous diseases, meningitis), tumor, cerebral aneurysm, or a blood clot.

In communicating hydrocephalus, faulty reabsorption of CSF may result from surgery to repair a myelomeningocele, adhesions between meninges at the base of the brain, or meningeal hemorrhage.

Signs & Symptoms of Hydrocephalus

Hydrocephalus sometimes has no symptoms (asymptomatic). When symptoms occur, they can include:

  • Enlarged skull (infants).
  • Headache
  • Nausea and vomiting
  • Decreased conscious state
  • Hearing sensitivities
  • Seizures
  • Difficulty in walking
  • Imbalance and dizziness
  • Incontinence
  • Irregular gait
  • Vision problems
  • Poor coordination

Diagnostic Tests

The various tests used to diagnose hydrocephalus include:

  • Physical examination
  • Eye examination
  • Computed tomography scanning
  • Skull X-rays
  • CT scan
  • MRI scan.
  • Magnetic resonance imaging


Surgical correction is the only treatment for hydrocephalus. Surgery is performed either to remove an obstruction to CSF flow or to implant a shunt to divert CSF flow. Usually, such surgery involves insertion of a ventriculoperitoneal shunt, which drains excess CSF fluid from the brain's lateral ventricle into the peritoneal cavity.

If a concurrent abdominal problem exists, the doctor may use a ventriculoatrial shunt, which drains fluid from the brain's lateral ventricle into the right atrium of the heart, where the fluid makes its way into the venous circulation.

Prevention Tips

Protect the head of an infant or child from injury. Prompt treatment of infections such as meningitis and other disorders associated with hydrocephalus may reduce the risk of developing the disorder.

If you're pregnant, you may reduce the risk of hydrocephalus in your unborn baby by taking precautions to reduce the likeliness of premature birth.

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