What Is Hydrocephalus? How Is Hydrocephalus Treated?

Estimated reading time: 7 minutes 53 seconds

When it comes to conditions affecting the brain, many questions naturally arise. One of the topics among these questions is hydrocephalus. Hydrocephalus, which can be seen in many different age groups, is a serious condition that may lead to significant consequences.

In this article, we will address the most frequently asked questions about hydrocephalus, from “what is hydrocephalus” to its treatment methods. If you are curious, this article may provide you with valuable insights. Let’s begin with the following question: What is hydrocephalus?

What is hydrocephalus?

Hydrocephalus is a condition caused by the excessive buildup of cerebrospinal fluid (CSF) in the brain’s ventricles. Normally, this fluid protects the brain against external factors, removes waste, and carries nutrients. However, when too much fluid accumulates, the ventricles begin to enlarge. Enlarged ventricles put pressure on the brain, and this pressure affects normal brain functions. Depending on age and the severity of the buildup, a variety of symptoms may occur.

As the name suggests, hydrocephalus is derived from the words hydro (water) and cephalus (head), meaning simply “water on the brain.” This condition can occur at any stage of life, from newborns to older adults. Its effects can vary greatly depending on its severity.

What are the types of hydrocephalus?

Hydrocephalus is not a single disease but rather a term covering a group of related disorders. Doctors classify hydrocephalus into different types depending on how and when it develops. Knowing these distinctions is important because treatment and disease progression may vary accordingly. The main types include:

• Congenital hydrocephalus: Present at birth, often due to genetic factors or developmental issues during pregnancy.
• Acquired hydrocephalus: Develops later in life, usually as a result of injury, infection, stroke, or tumors.
• Communicating hydrocephalus: CSF flow is blocked after leaving the ventricles, though it can still move between them.
• Non-communicating (obstructive) hydrocephalus: A blockage occurs within the ventricular system, preventing proper CSF circulation.
• Normal pressure hydrocephalus (NPH): Typically affects older adults. Despite its name, pressure can sometimes increase, leading to walking difficulties, memory issues, and bladder control problems.

What causes hydrocephalus?

There is no single answer to the question of what causes hydrocephalus. The reasons vary depending on age and type.

In infants, it may result from genetic abnormalities or developmental issues such as neural tube defects during fetal growth. In children and adults, hydrocephalus often occurs due to head trauma, brain hemorrhage, infections like meningitis, or tumors that block CSF flow.

Sometimes, especially in elderly patients with normal pressure hydrocephalus, the exact cause is not fully understood. In such cases, what is consistently observed is a disruption in the delicate balance between CSF production, circulation, and absorption.

What are the symptoms of hydrocephalus?

Because the brain and skull respond differently at various stages of life, symptoms of hydrocephalus can vary widely depending on age. In infants, one of the most prominent signs is a rapidly enlarging head. In children and adults, symptoms are usually milder but can still significantly affect daily life.

Some common symptoms include:

• In infants: Bulging soft spot (fontanel), vomiting, irritability, poor feeding, and developmental delays.
• In children: Headaches, vision problems, balance issues, coordination difficulties, and changes in school performance.
• In adults: Memory problems, walking difficulties, urinary incontinence, headaches, or drowsiness.
• In older adults with normal pressure hydrocephalus: The classic “triad” of walking difficulty, memory loss, and bladder control problems.

Since some of these symptoms overlap with other conditions, doctors rely on a combination of clinical signs and imaging results rather than just a single symptom when making a diagnosis.

How is hydrocephalus diagnosed?

The diagnostic process usually begins with reviewing the patient’s medical history and conducting a physical exam. Imaging tests then follow to evaluate the brain. The most common tests are MRI and CT scans, which can show enlarged ventricles or other abnormalities.

In infants, ultrasound can be performed through the soft spot on the skull, providing a safe and simple way to examine the brain. In adults suspected of having normal pressure hydrocephalus, additional tests such as lumbar puncture or continuous pressure monitoring may be used to assess CSF flow and drainage.

Timely and accurate diagnosis is critical, as early detection often leads to better outcomes.

Can hydrocephalus be treated?

Yes, hydrocephalus can be treated, but the treatment process is not as simple as taking a pill. It requires medical intervention. Thanks to modern treatment methods developed in recent years, managing hydrocephalus has become increasingly successful.

The primary goal of treatment is to improve CSF flow or absorption, thereby reducing pressure on the brain. With timely diagnosis and treatment, many patients with hydrocephalus can enjoy a satisfactory quality of life.

How is hydrocephalus treated?

Treatment for hydrocephalus usually involves surgery. The two most common surgical approaches are:

• Shunt system: A flexible tube is surgically placed into the brain’s ventricles to divert excess fluid to another part of the body (usually the abdominal cavity), where it can be absorbed. Shunt systems have been widely used for decades and are highly effective, though adjustments or replacements may sometimes be needed.
• Endoscopic third ventriculostomy (ETV): In this procedure, a small opening is made at the bottom of the third ventricle, allowing CSF to bypass the blockage and flow more freely. This method is often used for certain types of obstructive hydrocephalus and may eliminate the need for a shunt.

Both options carry risks and benefits. The choice depends on the patient’s age, type of hydrocephalus, and overall health. Doctors carefully evaluate these factors to determine the most suitable approach.

What is the life expectancy or long-term outlook for hydrocephalus?

Thanks to advances in diagnosis and treatment, the outlook for hydrocephalus has greatly improved. Although it remains a serious condition, many people can live long and near-normal lives after treatment.

Children who receive timely care can often grow and develop normally, though some may need ongoing therapies or educational support. Adults, especially those with normal pressure hydrocephalus, may experience significant improvements in mobility and memory after treatment.

However, hydrocephalus is often a lifelong condition. Shunts require monitoring and may need surgical revisions over time. Regular medical follow-up is essential to ensure treatment continues to work properly. With early diagnosis and proper care, many individuals with hydrocephalus can enjoy a good quality of life.