Hydrocephalus

Find out about hydrocephalus (fluid on the brain), including information about symptoms, causes, types, diagnosis, treatment and complications.

Hydrocephalus is a build-up of fluid on the brain. The excess fluid puts pressure on the brain, which can damage it.

If left untreated, hydrocephalus can be fatal.

This page covers:

Symptoms

Types

Diagnosis

Treatment

Complications of surgery

Causes

Symptoms of hydrocephalus

The damage to the brain can cause a wide range of symptoms, including:

  • headache
  • being sick
  • blurred vision
  • difficulty walking

Different types of hydrocephalus can cause specific symptoms.

Read more about the symptoms of hydrocephalus.

Types of hydrocephalus

There are three main types of hydrocephalus:

  • congenital hydrocephalus – hydrocephalus that's present at birth
  • acquired hydrocephalus – hydrocephalus that develops after birth
  • normal pressure hydrocephalus – usually only develops in older people

Hydrocephalus present from birth

Congenital hydrocephalus is when a baby is born with excess fluid on the brain.

It can be caused by a condition such as spina bifida, or an infection the mother develops during pregnancy, such as mumps or rubella (German measles).

It's estimated spina bifida affects one baby in every 1,000 born in Britain. Most of them will have hydrocephalus.

Many babies born with hydrocephalus (congenital hydrocephalus) have permanent brain damage.

This can cause a number of long-term complications, such as:

If your child has learning disabilities, they'll need extra support from their nursery or school to ensure their needs are being met.

Read more about special educational needs (SEN).

Hydrocephalus that develops in children or adults

Acquired hydrocephalus can affect children or adults. It usually develops after an illness or injury.

For example, it may occur after a serious head injury or as a complication of a medical condition, such as a brain tumour.

Normal pressure hydrocephalus (NPH)

Normal pressure hydrocephalus (NPH) is an uncommon and poorly understood condition that most often affects people over the age of 60.

It can sometimes develop after an injury or a stroke, but in most cases the cause is unknown.

Mobility problems, dementia and urinary incontinence are the main symptoms of NPH, but because they come on gradually and are similar to the symptoms of other, more common conditions, such as Alzheimer's disease, it can be difficult to diagnose.

Diagnosing hydrocephalus

Brain scans, such as CT scans and MRI scans, can be used to diagnose congenital and acquired hydrocephalus.

A checklist is used to help diagnose NPH. For example, how you walk, your mental ability and symptoms that affect your bladder control will be assessed.

It's important to diagnose NPH correctly because, unlike Alzheimer’s disease, the symptoms can be relieved with treatment.

Read more about diagnosing hydrocephalus.

Treating hydrocephalus

Hydrocephalus can usually be treated using a shunt, a thin tube that's surgically implanted in the brain and drains away the excess fluid.

An endoscopic third ventriculostomy (ETV) can sometimes be used as an alternative to shunt surgery.

During this procedure, a hole is made in the floor of the brain to allow the trapped CSF to escape to the surface, where it can be absorbed.

Read more about how hydrocephalus is treated.

Complications after surgery

The surgery used to treat hydrocephalus can sometimes cause complications. For example, a shunt can become blocked or infected.

Before having surgery, your surgeon should discuss the possible complications with you.

Read more about the complications of surgery for hydrocephalus.

What causes hydrocephalus?

In the past, hydrocephalus was often referred to as water on the brain. However, the brain isn't surrounded by water but by a fluid called cerebrospinal fluid (CSF).

CSF has three important functions:

  • it protects the brain from damage
  • it removes waste products from the brain
  • it provides the brain with the nutrients it needs to function properly

The brain constantly produces new CSF – about a pint a day – while old fluid is released from the brain and absorbed into the blood vessels.

But if this process is interrupted, the level of CSF can quickly build up, placing pressure on the brain.

Read more about the causes of hydrocephalus.

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