What is hydrocephalus?
Hydrocephalus is a condition in which too much fluid builds up and puts pressure on the brain. In Latin, hydro means “water” and “cephalus” means head. Because of this, hydrocephalus is defined as “water on the brain.” The "water" is actually cerebrospinal fluid (CSF), the clear fluid that surrounds the brain and spinal cord. Hydrocephalus occurs most often in newborns.
Hydrocephalus can happen on its own or may be part of a genetic syndrome or other health condition. Further genetic testing may be recommended after birth.
Symptoms of hydrocephalus
The symptoms of hydrocephalus in infants include:
A bulging soft spot on the top of the head (the anterior fontanel)
An unusually large head
Vomiting, sleepiness and irritability
Downward deviation of the eyes
Causes of hydrocephalus
It's normal for the body to produce CSF, which flows around the brain and spinal cord. Hydrocephalus can occur when a blockage develops in the flow of this fluid inside the brain. This causes swelling of the spaces in the brain called the ventricles. When the ventricles swell, they cause harmful pressure on the tissues of the brain. Another cause of hydrocephalus is when there is a problem absorbing the CSF fluid on the outside of the brain.
Some forms of hydrocephalus are genetic and recur in families. Further genetic testing is sometimes recommended.
Types of hydrocephalus
Hydrocephalus may be mild or severe. In mild cases, your child may have very few problems and otherwise typical development. In severe cases, the pressure on the brain can destroy brain tissue and result in brain damage and physical disabilities.
No matter how your child is affected, your Children's Mercy care team will be with you to provide support.
Your doctor may suspect hydrocephalus if your baby's head is measuring unusually large at the 20-week ultrasound. A fetal MRI can help your health care team to determine if there are any other underlying health issues causing the hydrocephalus.
The Fetal Health Center at Children's Mercy can provide prenatal screening and in some cases, intervention for babies with hydrocephalus. We will carefully monitor you and your baby with regular ultrasounds.
You may decide to deliver your baby in the Special Care Delivery unit at the Fetal Health Center so that the team can provide immediate care for your baby while you stay right there with them.
Sometimes, hydrocephalus develops after birth. If your child’s head circumference is growing too fast, your child’s provider may suspect hydrocephalus. They will examine your child, measure your child’s head and ask about the symptoms. If the head is too large for your child’s age, your provider may order scans, such as an ultrasound, CT scan or an MRI, to check for enlarged ventricles in the brain.
Your child’s health care provider will talk with you about what treatment options are available. Surgery is the most common treatment for hydrocephalus.
The surgeon usually places a tube called a ventricular peritoneal shunt, which goes from the brain to the abdomen or blood vessels near the heart. This allows the extra fluid to drain and be reabsorbed into the body. For a child, repeat surgery may be needed as they grow in order to lengthen the shunt tube.
A neurosurgeon (brain surgeon) will place the shunt in the operating room. Your baby is given anesthesia for the surgery.
The shunt may be replaced as your child grows, or if the shunt is blocked or infected.
Want a second opinion?
If you’ve recently received a diagnosis or would like a second opinion, experience matters. We're happy to share our expertise with you. Call (816) 855-1800 to make an appointment with our team.
Choosing the best home for your child's care
Children's Mercy's neurosurgery division is recognized by U.S. News & World Report as one of the top programs in the country.
Our staff provides consultations 24 hours a day for children with all types of neurosurgical conditions, including hydrocephalus, spina bifida, and traumatic injuries of the brain, spinal cord, and peripheral nerves.
Every surgery is attended by a pediatric anesthesiologist with extensive experience in administering anesthesia precisely measured for the child's age, size, and condition.
Children’s Mercy is the only Level IV NICU within a 200-mile radius, providing specialized services for babies who need surgery or highly advanced medical care. Every type of pediatric subspecialist (doctors who treat a certain system, like baby’s heart, lungs or kidneys) is available on-site and will work as a team to help your child.
Dr. Paul Grabb, Section Chief and Neurosurgeon
Dr. Paul Grabb, Section Chief and Neurosurgeon, is board certified by the American Board of Neurological Surgery and the American Board of Pediatric Neurological Surgery, and has special interest in hydrocephalus and spinal trauma. Here, Dr. Grabb shares how children inspire him to provide the best care.
Neonatal Follow-Up Clinics: Care for your growing child
We recognize that many of our NICU graduates have special health care needs related to growth and development. The Neonatal Follow-Up Clinics provide follow-up services for your baby after they are home from the NICU.
Families who have a loved one with hydrocephalus may need counseling or support. The Family Support and Resources at Children's Mercy can connect you with local resources and assistance. To connect with the community, contact the Hydrocephalus Association.