Hydrocephalus

Symptoms of hydrocephalus

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

• headache
• being sick
• blurred vision
• difficulty walking
• drowsiness
• seizures (fits)
• poor coordination of movement

Different types of hydrocephalus can cause specific symptoms.

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
• an infection the mother develops during pregnancy, such as mumps or rubella

Its 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:

• learning disabilities 
• impaired speech
• memory problems
• short attention span
• problems with organisational skills
• vision problems, such as a squint and visual impairment
• problems with physical co-ordination
• epilepsy 

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

• Children with special educational needs

Hydrocephalus that develops in children or adults

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

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 condition that most often affects people over the age of 60.

It can sometimes develop after:

• an injury
• a stroke

In most cases the cause is unknown.

The main symptoms of NPH are:

• mobility problems
• dementia
• urinary incontinence 

As these symptoms 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. The following will be assessed:

• how you walk
• your mental ability
• symptoms that affect your bladder control

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

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.

Complications after surgery

Following surgery to treat hydrocephalus, (inserting a shunt), there can sometimes be complications, such as:

• a shunt becoming blocked
• a shunt becoming infected

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

Causes of hydrocephalus

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

CSF has three functions:

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

The brain constantly produces new CSF. Old fluid is released from the brain and absorbed into the blood vessels. If this process is interrupted, the level of CSF can quickly build up, placing pressure on the brain.

More useful links

• Hydrocephalus
• How to use your health services