What to Know About Hydrocephalus

Hydrocephalus is a brain condition that causes a buildup of cerebrospinal fluid on the brain, creating significant pressure on the skull. We’re here to explain the causes, signs and symptoms and treatment options.

What Is Hydrocephalus?

Hydrocephalus is a brain condition that causes a buildup of cerebrospinal fluid (CSF), creating significant pressure on the skull. Different types of hydrocephalus are classified based on the flow of CSF and whether a person experiences a blockage.

The four main types of hydrocephalus are:

1. Communicating hydrocephalus: The flow of CSF is blocked at a point after it leaves your ventricles. The blockage prevents the free flow of CSF, even though your ventricles remain open.
2. Hydrocephalus ex-vacuo: This form of hydrocephalus is caused by a head injury or stroke. In these instances, the brain tissue around your ventricles shrinks and CSF builds up in your ventricles to fill in the extra space. Though this causes enlarged ventricles, the pressure in your head usually remains normal.
3. Normal pressure hydrocephalus (NPH): The buildup of CSF happens slowly, but while it does cause enlarged ventricles, there is little to no increase in skull pressure. NPH most often affects older adults.
4. Obstructive hydrocephalus: Also referred to as noncommunicating hydrocephalus, this type of hydrocephalus occurs when there is a blockage along one or more of the narrow passages that connect your ventricles.

Though hydrocephalus is most often associated with babies, children and adults can also develop the condition, which is why experts also classify hydrocephalus by onset as either congenital or acquired.

Hydrocephalus Causes

Congenital hydrocephalus is present in babies at birth and occurs during fetal development, whereas acquired hydrocephalus is developed later in life.

Congenital hydrocephalus can be caused by any of the following genetic or environmental factors:

• Aqueductal stenosis (a narrowing of the small passage between the third and fourth ventricles of your brain)
• Brain and spinal cord defects, such as spina bifida
• Complications resulting from premature birth, such as bleeding within ventricles
• Maternal infections during pregnancy that can cause inflammation in fetal brain tissue

Acquired hydrocephalus begins after birth and people can develop it at any age. The most common causes include:

• Brain or spinal cord tumors
• Head trauma
• Infections of the brain or spinal cord
• Stroke

There is not always an obvious cause of normal pressure hydrocephalus, but experts say it may also develop after hemorrhage or surgical complications.

Warning Signs and Symptoms

Symptoms of hydrocephalus can vary on a few factors, such as age and how far the disease has progressed.

Common symptoms of hydrocephalus at various ages may include:

With normal pressure hydrocephalus specifically, some people may experience symptoms that come and go due to fluctuations in excess fluid. However, no matter the diagnosis type, when left untreated, symptoms will worsen over time, which is why it’s important to talk with your doctor early to find a treatment option that will work for you. We’re here to help.

Treating Hydrocephalus

While there currently isn’t a way to prevent or cure hydrocephalus, it is manageable, especially when diagnosed early.

Though experts are researching noninvasive treatment techniques, such as drug or gene therapies, currently, the only way to treat hydrocephalus is with brain surgery. In most cases, a neurosurgeon may recommend a shunt placement, where a flexible tube is inserted into the brain to drain the excess CSF to another area of the body.

Another option for treatment is with an endoscopic third ventriculostomy (ETV), a minimally invasive procedure where a neurosurgeon will make a small hole in the floor of the third ventricle. This allows trapped CSF to drain into its normal pathway.

Treatment options will depend on the type and stage of your condition, as not all individuals are good surgical candidates. Early treatment is especially important for infants and young children, as hydrocephalus can affect brain development. If you’re concerned that you or a loved one may be showing signs of hydrocephalus, talk with your doctor right away to get an evaluation.

Caring for Your Whole Health

With surgery and ongoing monitoring, many people with hydrocephalus can live a full, vibrant life, but it’s important to seek care early. Our skilled neurology and neurosurgical teams are here to help you find answers and get compassionate, whole-person care. Learn more today.