Hydrocephalus

1 What is hydrocephalus?

Hydrocephalus is a condition that occurs when fluid builds up in the skull and causes the brain to swell. The name means “water on the brain.” Brain damage can occur as a result of the fluid buildup. This can lead to developmental, physical, and intellectual impairments. It requires treatment to prevent serious complications.

Hydrocephalus mainly occurs in children and adults over 60, but younger adults can get it too. The National Institute of Neurological Disorders and Stroke (NINDS) estimates that 1 to 2 of every 1,000 babies are born with hydrocephalus.

2 What causes hydrocephalus?

Cerebrospinal fluid (CSF) flows through your brain and spinal cord in normal conditions. Under certain conditions, the amount of CSF in your brain increases.

The amount of CSF can increase when:

• a blockage develops that prevents CSF from flowing normally
• there is a decrease in the ability of blood vessels to absorb it
• your brain produces an excess amount of it

Too much of this fluid puts your brain under too much pressure. This pressure can cause brain swelling, which can damage your brain tissue.

Underlying Causes

In some cases, hydrocephalus starts before a baby is born. This can result from:

• a birth defect in which the spinal column doesn’t close
• a genetic abnormality
• certain infections that occur during pregnancy, such as rubella

This condition can also occur in infants, toddlers, and older children due to:

• central nervous system infections such as meningitis, especially in babies
• bleeding in the brain during or shortly after delivery, especially in babies born prematurely
• injuries that occur before, during, or after delivery
• head trauma
• central nervous system tumors

Normal pressure hydrocephalus

When hydrocephalus occurs in adults, CSF levels rise but the amount of pressure is usually normal. It still causes the brain to swell and can lead to impaired functioning. In adults, this condition usually results from conditions that prevent CSF from flowing. However, in some cases, there is no known cause.

You might be at higher risk if you’ve experienced any of the following:

• brain-related infections such as meningitis
• head injuries
• bleeding from a blood vessel in your brain
• brain surgery

3 Recognizing potential signs of hydrocephalus

Hydrocephalus can cause permanent brain damage, so it’s important that you recognize symptoms of this condition and seek medical attention. The condition is more common in children, but it can affect people of any age.

A) Infants

Early signs of hydrocephalus in infants include:

• bulging fontanel, which is the soft spot on the surface of the skull
• a rapid increase in head circumference
• eyes that are fixed downward
• seizures
• extreme fussiness
• vomiting
• excessive sleepiness
• poor feeding
• low muscle tone and strength

B) Toddlers and Older Children

Symptoms or signs that affect toddlers and older children include:

• short, high-pitched cries
• personality changes
• changes in facial structure
• crossed eyes
• headaches
• muscle spasms
• delayed growth
• trouble eating
• extreme sleepiness
• irritability
• loss of coordination
• loss of bladder control
• larger than normal head
• trouble staying awake or waking up
• vomiting or nausea
• seizures
• problems concentrating

C) Young and Middle-aged Adults

Symptoms in young and middle-aged adults include:

• chronic headaches
• loss of coordination
• difficulty walking
• bladder problems
• vision problems
• poor memory
• difficulty concentrating

D) Normal Pressure Hydrocephalus (NPH)

This form of the condition usually begins slowly and is more common in adults over the age of 60. One of the earliest signs is falling suddenly without losing consciousness. Other common symptoms of normal pressure hydrocephalus (NPH) include:

• changes in the way you walk
• impaired mental functions, such as memory problems
• trouble controlling urine
• trouble controlling stools
• headaches