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Hydrocephalus


Hydrocephalus means “water on the brain”. It is a condition that occurs when fluid builds up in the cavities (ventricles) deep within the brain. It causes the brain to swell, increases the size of the ventricles and puts pressure on the brain.

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Facts about Hydrocephalus

  • Mainly occurs in children and adults over 60
  • Can be congenital, or present at birth
  • Leads to developmental, physical, and intellectual impairments

Causes of Hydrocephalus

 Hydrocephalus is caused by increased volume of CSF in brain. Volume of CSF may increase due to any of the following reasons:

  • Obstruction that may prevent normal flow of CSF
  • Decreased ability of blood vessels to absorb CSF
  • Excessive production of CSF by brain

Causes of hydrocephalus that starts before a baby is born:

  • Birth defect in which the spinal column doesn’t close
  • Genetic abnormality
  • Infections like rubella during pregnancy

Causes of hydrocephalus in infants, toddlers, and older children due to:

  • Central nervous system infections such as meningitis
  • Central nervous system tumors
  • Bleeding in the brain during or shortly after delivery
  • Injuries that occur before, during, or after delivery
  • Head trauma

Risk factors of Hydrocephalus

Individuals with following factors are at higher risk of developing hydrocephalus:

  • Brain-related infections such as meningitis
  • Brain tumor
  • Head injuries/trauma
  • Bleeding from a blood vessel in brain
  • Brain surgery

Symptoms of Hydrocephalus

It is very important to recognise hydrocephalus symptoms as early as possible due to its probability of causing permanent brain damage. Its symptoms are different are different stages of life and may include following according to age of the patient:

Symptoms of Hydrocephalus in Infants

  • Bulging of the soft spot on the surface of the skull
  • Rapid increase in head circumference
  • An unusually large head
  • Eyes fixed downward
  • Seizures
  • Irritability
  • Extreme fussiness
  • Vomiting
  • Excessive sleepiness
  • Poor feeding
  • Low muscle tone and strength

Symptoms of Hydrocephalus in Toddlers and Older Children

  • Larger than normal head
  • Short, high-pitched cries
  • Personality changes
  • Changes in facial structure
  • Crossed eyes
  • Headaches
  • Blurred or double vision
  • Muscle spasms
  • Delayed growth
  • Trouble eating
  • Poor appetite
  • Extreme sleepiness
  • Difficulty remaining awake or waking up
  • Irritability
  • Loss of coordination
  • Unstable balance
  • Loss of bladder control
  • Vomiting or nausea
  • Seizures
  • Problems concentrating
  • Decline in school performance

Symptoms of Hydrocephalus in Young and Middle-Aged Adults

  • Chronic headaches
  • Loss of coordination or balance
  • Difficulty walking
  • Difficulty in remaining awake or waking up
  • Bladder problems
  • Vision problems
  • Poor memory
  • Difficulty concentrating
  • Decline in memory

Symptoms of Hydrocephalus in Older adults Hydrocephalus in older individuals above 60 years of age is called Normal Pressure Hydrocephalus (NPH). Its symptoms include:

  • Suddenly falling without losing consciousness
  • Changes in the walking style
  • Impaired mental functions, such as memory problems
  • Progressive loss of other thinking or reasoning skills
  • Trouble controlling urine
  • Trouble controlling stools
  • Poor coordination or balance
  • Slower than normal movements
  • Headaches

Diagnosis of Hydrocephalus

Diagnosis of hydrocephalus requires thorough physical and neurological examination of the patient along with look out for any symptoms associated with hydrocephalus. In addition to this, following diagnostic tests may help the physician to confirm the diagnosis:

  • Ultrasound  
  • Magnetic resonance imaging (MRI) scans
  • Computerized tomography (CT) scans

Treatment of Hydrocephalus

Hydrocephalus is a fatal condition that should be treated as early as possible to prevent serious complications. Although treatment may not reverse the damage done to brain but it can definitely prevent further brain damage. Treatment may include any of the following:

Surgical options:

  • Shunt Insertion
  • Endoscopic third ventriculostomy


Authored by Dr. Shyam Sundar K

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Dr. Shyam Sundar K

Dr. Shyam Sundar K is an eminent name in the field of neurology. He is one of the best neurosurgeon in Chennai, Tamil Nadu

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