Hydrocephalus

Hydrocephalus is a condition caused by excessive fluid inside and around the brain. This can be caused by blockage of flow, lack of absorption, or the overproduction of the CSF or Cerebral Spinal Fluid that is created inside the ventricles. Too much CSF can cause fluid buildup leading to increased pressure inside the brain. In the case of a child, this can cause the expansion of the bones of the skull leading to a larger-than-normal appearance, which calls for prompt child care.

FAQs
1. What are the causes of Hydrocephalus?
Hydrocephalus is a common condition affecting about one out of 500 children. Here are the primary causes of this condition:

Overproduction of CS
Problems in absorbing the CSF
Blockage of CSF flow in the head

Hydrocephalus can occur as a congenital condition or can be acquired later. In babies with congenital aqueductal stenosis, this condition is genetic. There are some other conditions associated with hydrocephalus:

Birth injury
Bleeding inside the brain
Formation of an abnormal blood vessel inside the brain
Infections
Neural tube defects like spina bifida
Premature birth
Trauma
Tumors

2. Are there any symptoms of Hydrocephalus?
For every baby, the symptoms of hydrocephalus may differ. Here are some of the most common symptoms:

Bulging eyes
Developmental delays
Full and bulging fontanel (soft spot on the top of the head)
High-pitched cry
Inability of the baby to keep their head facing forward while looking upward.
Increased circumference of the head
Increased irritability
Less alert than usual
Poor feeding
Projectile vomiting
Prominent scalp veins
Seizures
Sleepiness

3. How can hydrocephalus be diagnosed?
For diagnosing hydrocephalus before birth, the pediatric orthopedic surgeon might recommend an ultrasound. This is a diagnostic imaging technique that uses a computer and high-frequency sound waves for creating images of organs, tissues, and blood vessels. This diagnostic method is used for viewing internal organs while they are functioning. It can be used for determining the size of the ventricles in the neonates and in the womb. It is able to check blood flow in different vessels. In most of the cases, hydrocephalus won’t develop at least before the third trimester.

After the baby is born, another diagnostic testing is done where the doctor obtains the complete history of the baby, prenatal and birth. This includes asking questions regarding family history of hydrocephalus and other medical conditions. Since hydrocephalus is associated with developmental delays, the pediatric neurologist might also ask about any developmental milestones. Since the baby’s head will appear larger than usual, its circumference will be measured and compared to a graph for identifying the normal and abnormal ranges. Here are the diagnostic tests that can be used for confirming the diagnosis of hydrocephalus:

Computed Tomography (CT scan) - This is a diagnostic imaging procedure using computer technology and X-rays for producing axial or horizontal

images of the body. The scan will display a detailed image of the body including fat, muscles, organs, and bones. They have more details than X-rays.
Magnetic Resonance Imaging (MRI) - This diagnostic imaging procedure uses a computer, radio frequencies, and large magnets for producing images of

structures and organs present inside the body.

4. What are the treatment options for hydrocephalus?
The treatment for hydrocephalus will be determined by the following:

The gestational age, medical history, and overall health of the baby
The severity of the condition
Expectations from the treatment
Your preference and opinion

The aim of the treatment at Rainbow Children’s Hospital by pediatric neurosurgeons is reducing the pressure inside the head of the baby and draining the CSF properly. In some cases, procedures or medications will be needed for drawing the extra CSF out. In others, neurosurgery might be required in which a mechanical shunting device is placed inside the baby’s head. It not only drains the extra CSF but also redirects it to another body part to be absorbed. The ventriculoperitoneal shunt is the most common type of shunt that redirects the CSF fluid into the abdominal cavity.