Hydrocephalus

What is hydrocephalus?

Hydrocephalus is a condition in which cerebrospinal fluid (CSF) builds up inside the brain’s fluid-filled spaces (ventricles). This leads to increased pressure on the brain or abnormal stretching of brain tissue.

Normally, CSF is continuously produced, circulates around the brain and spinal cord, and is absorbed into the bloodstream. Hydrocephalus occurs when this balance is disturbed.

Why does hydrocephalus happen?

Hydrocephalus can develop for several reasons, including:

• Blockage of normal CSF flow

• Reduced absorption of CSF

• Overproduction of CSF (rare)

It may occur:

• At birth (congenital)

• After brain hemorrhage, infection, trauma, or surgery

• In adulthood or older age, including a specific form called normal pressure hydrocephalus (NPH)

Common symptoms

Symptoms vary depending on age and type of hydrocephalus.

In adults, symptoms may include:

• Headache, nausea, or vomiting

• Problems with walking or balance

• Memory difficulties or slowed thinking

• Urinary urgency or incontinence

• Visual changes
  
  

In older adults with NPH, the classic triad is:

• Difficulty walking

• Cognitive decline

• Urinary control problems

Many of these symptoms can also occur in other conditions, which is why careful evaluation is essential.

How is hydrocephalus diagnosed?

Diagnosis typically includes:

• MRI or CT scans to assess ventricular size and brain structure

• Clinical neurological examination

• Specialized tests in selected cases to assess response to CSF drainage

A precise diagnosis helps determine whether treatment is likely to be beneficial.

Treatment options

Treatment depends on the cause and type of hydrocephalus and is always tailored to the individual patient. Options may include:

• Shunt surgery
  A small internal tube (shunt) diverts excess fluid from the brain to another part of the body, where it can be absorbed safely.

• Endoscopic treatment
  In selected patients, a minimally invasive endoscopic procedure can restore natural CSF flow without the need for a permanent shunt.

• Observation and follow-up
  In rare, stable cases with minimal symptoms, careful monitoring may be appropriate.

The primary goal is to relieve symptoms, protect brain function, and improve daily life.

What patients should know

• Hydrocephalus is a treatable neurological condition

• Early diagnosis often leads to better outcomes

• Not all patients need the same treatment

• Careful follow-up is important for long-term success