Hydrocephalus (brain fluid build-up)

Description Hydrocephalus is an...

Description

Hydrocephalus is an abnormal build-up of cerebrospinal fluid in the ventricles, most often associated with high pressure inside and around the brain. The ventricles are cavities inside the brain. CSF circulates from the ventricles, out through small holes into the area around the brain and spinal cord. New CSF is constantly being made inside the ventricles and reabsorbed through the surfaces around the brain. The CSF communicates between the ventricles through communication channels. Hydrocephalus can occur through blockage of these channels (Obstructive Hydrocephalus) or by decreased reabsorption of the CSF (Normal Pressure Hydrocephalus).

Symptoms

The symptoms experienced depend on the cause of the hydrocephalus and how quickly it occurs. In infants one may see a bulging of the fontanelle (the soft part of the skull on top of the head), an abnormally large head, poor development, irritability, poor feeding, vomiting, seizures, and muscle spasms. In older children and adults with obstructive hydrocephalus: headaches, blurred and/or double vision, nausea, vomiting, difficulty concentrating, change in behavior. In older people with normal pressure hydrocephalus: memory loss and confusion, problems walking, incoordination, urinary incontinence.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. A head CT scan and brain MRI are the best imaging study to identify hydrocephalus. The ventricles are usually enlarged. If the patient is an infant and the head size appears too large, a brain ultrasound may be done as a screening tool.

Tests:
CT Scan, Magnetic resonance imaging (MRI)

Specialists:
Neurology, Pediatric Neurosurgery

Treatment

The goals of therapy are to diagnose and treat the reason for the hydrocephalus and reduce the pressure in and around the brain. The most common procedure is a shunt that is surgically placed to drain fluid away from the ventricles.