Hydrocephalus

Hydrocephalus
Other namesWater on the brain
Hydrocephalus as seen on a CT scan of the brain. The black areas in the middle of the brain (the lateral ventricles) are abnormally large and filled with fluid.
Pronunciation
  • /ˌhdrˈsɛfələs/
SpecialtyNeurosurgery
SymptomsBabies: rapid head growth, vomiting, sleepiness, seizures
Older people: Headaches, double vision, poor balance, urinary incontinence, personality changes, mental impairment
CausesNeural tube defects, meningitis, brain tumors, traumatic brain injury, brain bleed during birth, intraventricular hemorrhage
Risk factorsSmoking
Diagnostic methodBased on symptoms and medical imaging
TreatmentSurgery
PrognosisVariable, often normal life
FrequencyVaries throughout the world, from 1 per 256 live births to 1 per 9,000, depending on access to prenatal health care, prenatal tests, and abortion

Hydrocephalus is a condition in which cerebrospinal fluid (CSF) builds up within the brain, which can cause pressure to increase in the skull. Symptoms may vary according to age. Headaches and double vision are common. Elderly adults with normal pressure hydrocephalus (NPH) may have poor balance, difficulty controlling urination, or mental impairment. In babies, there may be a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and downward pointing of the eyes.

Hydrocephalus can occur due to birth defects (primary) or can develop later in life (secondary). Hydrocephalus can be classified via mechanism into communicating, noncommunicating, ex vacuo, and normal pressure hydrocephalus. Diagnosis is made by physical examination and medical imaging, such as a CT scan.

Hydrocephalus is typically treated through surgery. One option is the placement of a shunt system. A procedure called an endoscopic third ventriculostomy has gained popularity in recent decades, and is an option in certain populations. Outcomes are variable, but many people with shunts live normal lives. However, there are many potential complications, including infection or breakage. There is a high risk of shunt failure in children especially. However, without treatment, permanent disability or death may occur.

Hydrocephalus affects about 0.1-0.6% of newborns. Rates in the developing world may be higher. Normal pressure hydrocephalus affects about 6% of patients over 80. Description of hydrocephalus by Hippocrates dates back more than 2,000 years. The word hydrocephalus is from the Greek ὕδωρ, hydōr, meaning 'water' and κεφαλή, kephalē, meaning 'head'.