Hydrocephalus is a condition in which excess cerebrospinal fluid (CSF) builds up within the ventricles (fluid-containing cavities) of the brain and may increase pressure within the head. Although hydrocephalus is often described as "water on the brain," the "water" is actually CSF, a clear fluid surrounding the brain and spinal cord.

CSF has three crucial functions:

  1. It acts as a "shock absorber" for the brain and spinal cord
  2. It acts as a vehicle for delivering nutrients to the brain and removing waste
  3. It flows between the cranium and spine to regulate changes in pressure within the brain

Hydrocephalus can occur at any age but is most common in infants and adults age 60 and older. Here at MD West ONE, we have Neurosurgery and Spine Specialists that can properly diagnose any spinal or neurological issues.



Symptoms of hydrocephalus vary greatly from person to person. Some of the most common are:

  • Infants: Abnormal enlargement of the head; soft spot (fontanel) is tense and bulging; scalp can appear thin; bones separated in baby's head; prominent scalp veins; vomiting; drowsiness; irritability; downward deviation of baby's eyes; seizures; or poor appetite.
  • Toddlers/Children: Abnormal enlargement of baby's head; headache; nausea; vomiting; fever; blurred or double vision; unstable balance; irritability; sleepiness; delayed progress in walking or talking; poor coordination; change in personality; inability to concentrate; loss of sensory-motor functions; seizures; or poor appetite. Older children may experience difficulty in remaining awake or waking up.
  • Young and Middle-aged adults: Headache; difficulty in remaining awake or waking up; loss of coordination or balance; bladder control problems; impaired vision and cognitive skills that may affect job performance and personal skills.
  • Older Adults: Loss of coordination or balance; shuffling gait, memory loss; headache; or bladder control problems.

Diagnosing Hydrocephalus 

Before your doctor can recommend a course of treatment, he or she will:

  • Review your medical history, and perform a physical examination
  • Perform a complete neurological examination including diagnostic testing if needed
  • Ask specific questions to determine if symptoms are caused by hydrocephalus

Further tests such as ultrasound (if the patient is an infant), computed tomography (CT or CAT scan), or magnetic resonance imaging (MRI) may be ordered. 

Causes of Hydrocephalus

Although rare, hydrocephalus can be inherited genetically or may be associated with developmental disorders, including spina bifida (congenital defect of the spine) and encephalocele (hernia of the brain). Other causes can include bleeding within the brain, brain tumors, head injuries, complications of premature birth such as hemorrhage, or diseases such as meningitis or other infections. In some cases, the normal flow of CSF within the brain is blocked, resulting in fluid build-up.

When Surgery is Necessary

Hydrocephalus can be treated in a variety of ways. The problem area may be treated directly (by removing the cause of CSF obstruction), or indirectly (by diverting the fluid to somewhere else; typically to another body cavity). Indirect treatment is performed by implanting a device known as a shunt to divert the excess CSF away from the brain.

In some cases, two procedures are performed, one to divert the CSF, and another at a later stage to remove the cause of obstruction (e.g., a brain tumor). Once inserted, the shunt system usually remains in place for the duration of a patient's life (although additional operations to revise the shunt system are sometimes needed). The shunt system continuously performs its function of diverting the CSF away from the brain, thereby keeping the intracranial pressure within normal limits

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