Hydrocephalus | |
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Other names | Water on the brain[1] |
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Hydrocephalus as seen on a CT scan of the brain. The black areas in the middle of the brain (the lateral ventricles) are abnormally large and filled with fluid. | |
Pronunciation | |
Specialty | Neurosurgery |
Symptoms | Babies: rapid head growth, vomiting, sleepiness, seizures[1] Older people: Headaches, double vision, poor balance, urinary incontinence, personality changes, mental impairment[1] |
Causes | Neural tube defects, meningitis, brain tumors, traumatic brain injury, brain bleed during birth, intraventricular hemorrhage[1] |
Diagnostic method | Based on symptoms and medical imaging[1] |
Treatment | Surgery[1] |
Prognosis | Variable, often normal life[1] |
Frequency | Varies throughout the world, from 1 per 256 live births to 1 per 9,000, depending on access to prenatal health care, prenatal tests, and abortion[1][3] |
Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain.[1] This typically causes increased pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and downward pointing of the eyes.[1]
Hydrocephalus can occur due to birth defects or be acquired later in life.[1] Associated birth defects include neural tube defects and those that result in aqueductal stenosis.[1][4] Other causes include meningitis, brain tumors, traumatic brain injury, intraventricular hemorrhage, and subarachnoid hemorrhage. The four types of hydrocephalus are communicating, noncommunicating, ex vacuo, and normal pressure. Diagnosis is typically made by physical examination and medical imaging.[1]
Hydrocephalus is typically treated by the surgical placement of a shunt system.[1] A procedure called a third ventriculostomy is an option in some people.[1] Complications from shunts may include overdrainage, underdrainage, mechanical failure, infection, or obstruction.[1] This may require replacement.[1] Outcomes are variable, but many people with shunts live normal lives.[1] Without treatment, permanent disability or death may occur.[1]
About one to two per 1,000 newborns have hydrocephalus.[1][3] Rates in the developing world may be higher.[5] Normal pressure hydrocephalus is estimated to affect about 5 per 100,000 people, with rates increasing with age.[6] Description of hydrocephalus by Hippocrates dates back more than 2,000 years.[5] The word hydrocephalus is from the Greek ὕδωρ, hydōr, meaning 'water' and κεφαλή, kephalē, meaning 'head'.[7]