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What is hydrocephalus? — Hydrocephalus the medical term for when there is too much spinal fluid in the brain. Spinal fluid is fluid that surrounds and protects the brain and spinal cord. In some people, too much spinal fluid can put pressure on the brain. Hydrocephalus is sometimes called "water on the brain."
Babies who are born too early or born with a brain problem are more likely to get hydrocephalus. A head injury or other problem that affects the brain can also cause the problem in people at any age.
What are the symptoms of hydrocephalus? — In babies, the main symptom is a head that:
Is bigger than normal
Grows larger very fast
Has an odd shape
Has an outward bulge at the soft spot on the top of the head
Has veins that bulge out
In older babies and children, symptoms can include:
A head that is bigger than normal
Headaches (often in the morning)
Eyes that stay looking down and cannot look up
Feeling sick (nausea) and throwing up (vomiting)
Not feeling hungry
Feeling sleepy
Is there a test for hydrocephalus? — Yes. In newborns, doctors use an ultrasound, a test that uses sound waves to take pictures of the brain. The doctor or nurse also measures the baby's head to see how fast it is growing. In older children, doctors use other imaging tests such as an MRI or CT scan to take a picture of the brain.
The doctor might also do a "lumbar puncture" (sometimes called a "spinal tap"). During this procedure, he or she puts a thin needle into the child's lower back and removes a small amount of spinal fluid to check it for problems.
How is hydrocephalus treated? — Doctors treat hydrocephalus with surgery that creates a way for the extra spinal fluid to drain from the brain. There are 2 types of surgery that are most often performed to treat hydrocephalus:
Shunt – A shunt is a device that goes in the fluid-filled space inside the brain. It is connected to a tube that is placed under the skin and that empties into the belly, heart, or chest. The shunt helps drain the extra spinal fluid from the brain (figure 1).
Third ventriculostomy – This type of surgery creates a small opening in part of the brain to help drain extra spinal fluid.
The type of surgery used depends on how old the child is and what caused the hydrocephalus.
What will my child's life be like? — Most children who have surgery for hydrocephalus will need at least 1 more surgery to fix or change the shunt system. This is called a "shunt revision." Many children need multiple surgeries over their lifetime. The reason for this is because as the child grows, the shunt tubing can stretch or move out of place. Over time, the shunt system can fail for other reasons.
Problems that can happen in children treated for hydrocephalus include:
A problem with the shunt – Shunts sometimes get infected or stop working. If this happens, the child can get sick suddenly. The symptoms can include fever, headache, or vomiting. If these symptoms develop, the child should see a doctor right away.
Seizures – Seizures are waves of abnormal electrical activity in the brain. The child might have jerking movements, get stiff, stop responding and stare for a few seconds, or pass out. If a child starts having seizures, he or she should see a doctor right away.
Developmental delays – Some children with hydrocephalus have developmental delays and learning problems. They might not reach certain milestones (like learning how to sit, walk, and talk) at the age that most children do, or at all. If your child's doctor is concerned about this, he or she might refer you to an "early intervention" program to help. Some children with learning problems need a special learning plan for school.
Can adults get hydrocephalus? — Yes. Adults can get hydrocephalus after a head injury or other problem with the brain. In some cases, adults have the same symptoms as children.
Some older adults get a type called "normal pressure hydrocephalus." The symptoms include:
Problems with thinking and memory
Trouble walking
Leaking urine or other bladder control problems
The tests and treatments for hydrocephalus in adults are the same as for children.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83447 Version 6.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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