Frequently Asked Questions (FAQ)
Hydrocephalus is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Although hydrocephalus was once known as "water on the brain," the "water" is actually cerebrospinal fluid (CSF) -- a clear fluid surrounding the brain and spinal cord. The excessive accumulation of CSF results in an abnormal dilation of the spaces in the brain called ventricles. This dilation causes potentially harmful pressure on the tissues of the brain. Hydrocephalus may be congenital or acquired. Congenital hydrocephalus is present at birth. Acquired hydrocephalus develops at the time of birth or at some point afterward. NPH or Normal Pressure Hydrocephalus is an accumulation of CSF that causes the ventricles in the brain to become enlarged with little or no increase in intracranial pressure.
What causes it?
Causes of acquired hydrocephalus include head injuries, tumors, cysts, intraventricular hemorrhage (IVH) and Neuronitis. Some causes of congenital hydrocephalus are toxoplasmas, Cytomegalovirus (CMV) infection, Rubella and neurological malformations such as anencephaly, spina bifida and Dandy Walker syndrome.
What are the symptoms?
Symptoms of hydrocephalus vary with age, disease progression, and individual differences in tolerance to CSF. In infancy, the most obvious indication of hydrocephalus is often the rapid increase in head circumference or an unusually large head size. In older children and adults, symptoms may include headache followed by vomiting, nausea, papilledema (swelling of the optic disk, which is part of the optic nerve), downward deviation of the eyes (called "sunsetting"), problems with balance, poor coordination, gait disturbance, urinary incontinence, slowing or loss of development, lethargy, drowsiness, irritability, or other changes in personality or cognition, including memory loss. Hydrocephalus is diagnosed through clinical neurological evaluation and by using cranial imaging techniques such as ultrasonography, computer tomography (CT), magnetic resonance imaging (MRI), or pressure-monitoring techniques.
What are the available treatments?
Hydrocephalus is most often treated with the surgical placement of a shunt system. This system diverts the flow of CSF from a site within the central nervous system to another area of the body where it can be absorbed as part of the circulatory process. A shunt has a valve connected to a flexible but sturdy plastic tube. A limited number of patients can be treated with an alternative procedure called third ventriculostomy. In this procedure, a small hole is made in the floor of the third ventricle, allowing the CSF to bypass the obstruction and flow toward the site of resorption around the surface of the brain.
Where can I find more information?
For more information about Hydrocephalus, various support groups, publications and more, please visit the resources page.