Hydrocephalus

What is hydrocephalus?

Hydrocephalus is a condition in which there is excessive fluid in and around the brain. It occurs from a lack of absorption, blockage of flow, or overproduction of the cerebral spinal fluid (CSF) that's made inside the ventricles. The ventricles are fluid-filled areas of the brain. The CSF disperses from the ventricles around the brain and spinal cord. Too much CSF may result in a buildup of fluid that can cause the pressure inside of the head to increase. In a child, this causes the bones of the skull to expand and separate to a larger-than-normal appearance.

Prevention & Risk Treatment

Prevention & Risk Treatment

What causes hydrocephalus?

Illustration of hydrocephalus

Hydrocephalus occurs in approximately one out of 500 births. The following are the primary reasons why hydrocephalus occurs:

  • Blockage of the CSF flow inside of the head

  • Problems absorbing CSF

  • Overproduction of CSF (rare)

Hydrocephalus can occur either as a condition present at birth (congenital), or it can be acquired later in life. In some babies the condition is genetic, such as in babies with congenital aqueductal stenosis. Other conditions, such as neural tube defects (like spina bifida), are also associated with hydrocephalus. Other causes include premature birth, infections, tumors, or bleeding inside the brain. 

Causes of acquired hydrocephalus may include:

  • Tumor

  • Infection

  • Prematurity

  • Bleeding inside the head

  • Birth injury

  • Abnormal blood vessel formation inside of the head

  • Trauma

What are the symptoms of hydrocephalus?

The following are the most common symptoms of hydrocephalus in babies. However, each baby may experience symptoms differently. Symptoms may include:

  • A full or bulging fontanel (soft spot located on the top of the head)

  • Increasing head circumference (size)

  • Seizures

  • Bulging eyes and an inability of the baby to look upward with the head facing forward

  • Prominent scalp veins

  • Increased irritability

  • High-pitched cry

  • Poor feeding

  • Projectile vomiting

  • Sleepiness or less alert than usual

  • Developmental delays

The symptoms of hydrocephalus may resemble other conditions or medical problems. Always consult your baby's doctor for a diagnosis.

Diagnosis

Diagnosis

How is hydrocephalus diagnosed?

Hydrocephalus may be diagnosed before birth by prenatal ultrasound, a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels. In many cases, hydrocephalus doesn't develop until the third trimester of the pregnancy and, therefore, may not be seen on ultrasounds performed earlier in pregnancy.

The diagnosis of congenital hydrocephalus may be made at birth and after diagnostic testing. During the examination, the doctor obtains a complete prenatal and birth history of the baby. He or she may also ask if there's a family history of hydrocephalus or other medical problems. The doctor will also ask about developmental milestones in older babies since hydrocephalus can be associated with developmental delay. Developmental delays may require further medical follow-up for underlying problems.

The baby's head may appear larger than normal. A measurement of the circumference of the baby's head is taken and compared to a graph that can identify normal and abnormal ranges for a baby's age.

Diagnostic tests that may be performed to confirm the diagnosis of hydrocephalus include:

  • Ultrasound. This diagnostic procedure uses sound waves to create an image of an internal portion of the body and can be used to determine the size of the ventricles in the womb and in neonates.
  • Magnetic resonance imaging (MRI). This diagnostic procedure uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.
  • Computed tomography (CT) scan. This diagnostic imaging procedure uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
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Kalicia's Story

"We chose Children's National because of their excellent neurosurgical staff and their specialization in newborn and children's conditions."

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Erieon's Story

"On her seventh birthday, a few of the nurses got together to sing to my daughter for her birthday. It brought tears to my eyes because they had became my support system, my family, and my friends."

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Austin's Story

"People always tell me 'You're so strong, I don't know how you got through it.' I like to say that you never know how strong you are or what you are capable of until you have no choice but to be strong." 

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Omari's Story

"Hydrocephalus does not define who he is. We are all stronger and less fragile than we ever imagined possible."

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"Everything may look pretty overwhelming now, but remember that you are not alone. You are part of a much larger family now - the Children's National family."

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Connor M.'s Story

"Besides the excellent medical care Connor received, I most appreciated the kindness, patience and understanding the Center's staff showed to my son, his mom, and me. There was nothing they wouldn't do for us."

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