What is hydrocephalus?
A baby with hydrocephalus has extra fluid in and around the brain. This fluid is called
cerebrospinal fluid (CSF). Most CSF is found in fluid-filled areas (ventricles) inside
the brain. Its purpose is to cushion and protect the brain and the spinal cord.
Too much CSF can increase the pressure in your baby’s head. This causes the bones
in your baby’s skull to expand and separate. The baby's head may look larger than
What causes hydrocephalus?
Hydrocephalus is rare. It may be caused by the following:
- The fluid is blocked from flowing through your baby’s head.
- Your baby has problems absorbing the fluid.
- Your baby makes too much fluid. This happens in rare cases.
This condition can be congenital. This means that your baby is born with it. Hydrocephalus
can also happen later in life. Causes of this condition include:
- Congenital aqueductal stenosis (narrowing of the aqueduct)
- Neural tube defects, such as spina bifida
- Premature birth
- Bleeding inside your baby’s brain
- Birth injuries
- Blood vessels in your baby’s head that aren’t formed right
What are the symptoms of hydrocephalus?
Symptoms can occur a bit differently in each child. They can include:
- A full or bulging soft spot on the top of your baby’s head (fontanel)
- Increasing head size (circumference)
- Bulging eyes and not being able to look up when facing forward
- Visible scalp veins
- High-pitched cry
- Poor feeding
- Projectile vomiting
- Sleepiness or bring less alert than usual
- Developmental delays
The symptoms of hydrocephalus may seem like symptoms of other conditions. Make sure
your child sees his or her healthcare provider for a diagnosis.
How is hydrocephalus diagnosed?
A healthcare provider may first spot this condition in your baby during an ultrasound
in pregnancy. In many cases, hydrocephalus doesn't develop until the third trimester
of the pregnancy. Ultrasounds done earlier in pregnancy may not show this condition.
Your child may be diagnosed with this condition after birth. Your child’s healthcare
provider will examine your child and ask you about your child’s prenatal, birth, and
family history. If your baby is older, your child’s provider may ask if he or she
is meeting milestones. Children with this condition may be likely to have developmental
delays. If your child has a delay, his or her healthcare provider may check for underlying
Your baby’s head may be larger than normal. Your child’s healthcare provider will
measure his or her head. If your baby’s head size isn’t in the normal range, he or
she will have tests. These tests can confirm hydrocephalus.
This test uses sound waves to create an image of the inside of the body. During pregnancy,
this test can show the size of the ventricles inside of your baby’s head.
This test uses large magnets, radio frequencies, and a computer. Together, these show
detailed images of organs and structures inside your baby’s body.
This test uses X-rays and computer technology to make detailed images of any part
of your baby’s body. These include bones, muscles, fat, and organs. CT scans are more
detailed than X-rays.
What is the treatment for hydrocephalus?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
The goal of treatment is to reduce the pressure inside your baby's head. This can
be done by draining the fluid. Your child may need medicine to remove the extra fluid.
Some children need surgery.
In surgery, a doctor usually places a mechanical shunting device in your baby’s head.
This helps to drain the fluid from your baby’s brain. The fluid is directed to another
part of your baby’s body, where it can be absorbed.
The shunt usually runs behind your baby’s ear. The tubing goes under your baby’s skin
to the belly (abdomen), heart, or lung. Your baby's healthcare provider will decide
the drainage location. This will be based on your baby’s condition, age, and other
factors. The belly is generally the first choice. A VP (ventriculoperitoneal) shunt
is often used to direct fluid into the abdomen.
What are the complications from the shunts or surgery for hydrocephalus?
Sometimes surgery and shunts can cause problems. Possible complications include:
- A shunt that doesn’t work. It may drain too much or not enough fluid.
After surgery, your child’s healthcare team will tell you how to care for your baby
at home. They’ll also tell you symptoms that are an emergency. If your child has these
symptoms, call his or her healthcare provider right away.
Can hydrocephalus be prevented?
Your baby’s healthcare provider may suggest genetic counseling if you plan to have
more children. Through counseling, you can learn about the risk for this condition
in future pregnancies. You may also need testing during pregnancy to check for hydrocephalus.
How is hydrocephalus managed?
Hydrocephalus can affect your baby’s brain and development. Your child’s outlook depends
on how severe his or her condition is. It also depends on other brain and health problems
your baby has.
The key to treating this condition is getting it diagnosed and treated early, and
avoiding infections. Your baby will need regular checkups to make sure his or her
shunt is working right. Your child’s healthcare team will work closely with you as
your baby grows.
Key points about hydrocephalus
- A baby with hydrocephalus has extra cerebrospinal fluid (CSF) around the brain. The
baby's head may look larger than normal.
- This is a rare condition.
- A healthcare provider may diagnose this condition during an ultrasound in pregnancy.
- The goal of treatment is to reduce the pressure inside your baby's head. This is done
by draining the fluid or decreasing its production.
- The key to treating this condition is getting it diagnosed and treated early, and
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.