Hydrocephalus

Brief Information

Introduction

Hydrocephalus is a condition that occurs when there is too much cerebrospinal fluid in the ventricles (cavities) of the brain.

Cerebrospinal fluid (CSF) is produced in the brain, and is needed by the body to protect the brain and spinal cord, and carry away waste from brain cells. It flows continuously through the ventricles of the brain and over the surface of the brain and spinal cord. Any excess CSF usually drains away from the brain and is absorbed by the body. For people with hydrocephalus, this doesn't happen, and the fluid instead builds up in the ventricles.

Too much cerebrospinal fluid puts a harmful amount of pressure on tissues in the brain - treatment is needed to release this pressure. Hydrocephalus can be congenital (present at birth), or develop later in childhood or adulthood. Normal pressure hydrocephalus (NPH) is a type of hydrocephalus, which usually develops in people over 60, because the drainage of the CSF gradually becomes blocked.

Causes

There are many possible causes for hydrocephalus. The reason for congenital hydrocephalus isn't known, but it is believed that damage to the blood supply, or an infection, may affect the baby's development before birth. Many babies with hydrocephalus are also born prematurely.

Hydrocephalus is also often associated with conditions that affect the brain and/or spinal column, such as meningitis and spina bifida. Currently, 80-90% of people with spina bifida also have hydrocephalus . Other types of the condition can also be caused by cysts or tumours in the brain that block the flow of the cerebrospinal fluid. In some cases, problems with the shape and formation of blood vessels can also be a cause.

Treatment

The main aim of any treatment for hydrocephalus is to release the pressure on the brain caused by the build up of cerebrospinal fluid. If the cause of the hydrocephalus is a tumour on the brain, then surgery to remove the tumour may be carried out. For all other causes, a shunt operation may be required.

A shunt is a thin tube that is implanted permanently in the brain, allowing the excess fluid to drain away to another part of the body, where it can be absorbed. Many people find that this operation greatly reduces the symptoms of hydrocephalus, but sometimes it doesn't make a big difference. This procedure may not be suitable for everyone - your specialist will be able to advise you whether it would be appropriate for you.

For a small number of people with hydrocephalus (depending on the type), a procedure called endoscopic third ventriculostomy (ETV) may be performed instead of shunt surgery. During this procedure the surgeon creates a small hole in one of the ventricles in the brain. This allows the excess fluid to drain away from the brain, and then be absorbed by the body.

As hydrocephalus affects both mental and physical development, a team of specialists is often required to assist with treatment for this condition. But with the right treatment and a lot of support, many people with hydrocephalus lead normal lives, with few limitations.

More Information

• Hydrocephalus and spina bifida information - Association for spina bifida and hydrocephalus

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