Hydrocephalus is a buildup of cerebrospinal fluid, or CSF, in the brain.
This fluid surrounds the brain and spinal cord to cushion and support them.
When there is a build-up of CSF, this can put pressure on the brain, which can lead
to problems.
Cerebral spinal fluid is made constantly by a tissue within the ventricles of the brain.
The CSF circulates through the ventricles, down around the spinal cord, and over the
surface of the brain.
Once on the surface of the brain, CSF is reabsorbed back into the blood stream.
The creation, circulation, and reabsorption of CSF is a constant and steady cycle.
Any time there is a blockage, a problem with re-absorption, or overproduction of CSF, the
fluid builds up and hydrocephalus occurs as a result.
There are many causes of hydrocephalus.
Some children are born with hydrocephalus and sometimes the exact cause is never known.
Other times, the cause can be identified, such as when there is a physical blockage
in the fluid cycle or an associated medical problem known to cause a blockage.
Blockages can be congenital, meaning they are present at birth, or they can be caused
by lesions such as brain tumors, infections, or cysts.
Hydrocephalus is also associated with certain birth defects such as spina bifida.
Anyone can develop hydrocephalus.
Children who are born with congenital hydrocephalus are often diagnosed before birth or during
infancy.
The typical signs and symptoms of hydrocephalus are associated with increased pressure inside
the brain and skull.
Symptoms can include and are not limited to the following: worsening headaches often with
nausea and/or projectile vomiting; drowsiness, and vision changes, and irritability.
You may see only one or two warning signs at a time.
Signs and symptoms of hydrocephalus can be quite different in infants and toddlers.
Because the bones of the skull are not yet fused together in this age group, they may
show no signs other than a rapidly increasing head size.
In infants with a cranial “soft spot,” a cranial ultrasound can be done to assess
the fluid spaces.
It can identify whether or not hydrocephalus is present, but is often not sensitive enough
to help determine the cause.
Often a CT scan or MRI will also be necessary if hydrocephalus is present.
At Children’s Hospital Colorado, treatment of Hydrocephalus typically includes the placement
of a shunt.
The body continues to produce cerebrospinal fluid even when there is a buildup and a shunt
is placed as an alternative pathway for the CSF.
A shunt is a narrow and flexible tube that allows the CSF to leave the brain and go somewhere
else in the body to get reabsorbed.
Typically, the CSF is re-routed to the abdomen.
In certain circumstances, instead of a shunt the Neurosurgeons can use a minimally invasive
procedure, called an endoscopic third ventriculostomy or ETV, to create an alternative pathway for
fluid.
During this procedure, a small hole is made in one of the ventricles so that the CSF can
bypass an obstruction.
This procedure can only be used in certain types of hydrocephalus.
For more information about Hydrocephalus, please visit the Children’s Hospital Colorado
website.