Hydrocephalus

WHAT IS HYDRO-
CEPHALUS?

According to the National Institute of Neurological Disorders and Stroke (NINDS), anywhere from one to two babies out of every 1,000 are born with hydrocephalus. Hydrocephalus is a condition that occurs when cerebrospinal fluid (CSF) fluid doesn’t properly drain from the brain. CSF is the watery, clear fluid that cushions and surrounds the brain and spinal cord.

When the cerebrospinal fluid fails to drain, it places the brain under excessive pressure and causes swelling, which damages the brain tissue. Hydrocephalus is directly related to intellectual, developmental, and physical impairments.

Hydrocephalus can begin before the baby is born from spinal column birth defects and genetic abnormalities. It can also begin while the child is in the womb as a result of certain pregnancy infections, such as rubella. Hydrocephalus can also occur in infants, toddlers, and adolescents due to:

Central nervous system tumors
Head trauma
Injuries before, during, or after delivery
Brain bleeding during or after delivery
Meningitis and other central nervous system infections

Symptoms

Symptoms of hydrocephalus vary depending on the age of onset but may include:

Rapid increase in head circumference or unusually large head size
Seizures
Bulging eyes and an inability of the baby to look upward
Prominent scalp veins
Increased irritability
High-pitched cry
Poor feeding
Projectile vomiting
Sleepiness or less alert than usual
Developmental delays

Treatment

If left untreated, hydrocephalus can be fatal. While treatment may not reverse the brain damage that has already happened, the goal of treatment is to prevent the brain damage from progressing further. Physicians typically explore one of the following medical treatment options:

Shunt Insertion – A shunt, which is a drainage system comprised of a valve and a long tube, is surgically inserted. The valve helps facilitate the flow of cerebrospinal fluid in the right direction at a normal rate. Excess fluid from the brain drains out on the other end of the tube into the abdominal cavity or chest.
Endoscopic Third Ventriculostomy (ETV) – As an alternative to the shunt procedure, a ventriculostomy involves creating a hole between or at the bottom of the ventricles. The placement allows the cerebrospinal fluid to safely leave the brain. This process involves the use of a tiny endoscope, which is a camera, to complete the procedure. Children who have an ETV may avoid the need to have the shunt replaced, getting infections, and other complications associated with shunts.