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Hydrocephalus Hydrocephalus
by Kimberly Allen, RN Hydrocephalus is a condition in which there is a build up of cerebral spinal fluid around the brain, that’s why... Hydrocephalus

by Kimberly Allen, RN

Hydrocephalus is a condition in which there is a build up of cerebral spinal fluid around the brain, that’s why it has been called “water on the brain”.  It is one of the most commonly diagnosed birth defects with at least 1 out of every 500 births every year having the condition.  In addition to that another 6,000 children develop hydrocephalus in the first 2years of their life every year.  approximately 50% of all diagnosed cases of hydrocephalus are congenital.  Although hydrocephalus is more common in infants and the elderly it can occur at any age.  This condition affects both males and females of all ethnic groups and socioeconomic backgrounds.  Also, in the US every 15 seconds there is a brain injury some of them lead to the development of hydrocephalus.hydrocephalus

Cerebral spinal fluid is the fluid that circulates around the brain and spinal cord.  It protects as well as delivers nutrients and removes waste from the brain.  It flow through the ventricles, which are narrow passage ways, of the brain leaving through a small reservoir called the cistern located at the base of the brain.  Any thing that impairs this flow can cause the cerebral spinal fluid to build up causing there to be too much fluid around the brain.  Cerebral spinal fluid can also build up if the area of the brain that produces the cerebral spinal fluid, know as the choroid plexus, produces too much cerebral spinal fluid.  It can also occur if the cerebral spinal fluid is not absorbed properly into the bloodstream.  Though there are many things that can cause hydrocephalus some people develop the condition without having a “known” cause.

There are different types of hydrocephalus.  It can be either congenital or acquired, congenital being present at birth while acquired hydrocephalus forms either at birth or at sometime after birth.  Acquired hydrocephalus can occur in anyone at any age and is usually caused by disease or injury.  You can also have communicating or non-communicating hydrocephalus.  Communicating hydrocephalus occurs when the blockage occurs after the fluid leaves the ventricles.  It is because the ventricle remain open and the fluid can continue to flow between them that this type is called communicating hydrocephalus.  Non-communicating or obstructive hydrocephalus develop when the blockage occurs in one or more of the narrow passages that connect the ventricles.    There are also 2 types of hydrocephalus that primarily affects adults, normal pressure hydrocephalus and hydrocephalus exo-vaco.  Hydrocephalus exo-vaco develops when a traumatic injury or stroke has damaged the brain.  Normal pressure hydrocephalus is most common in the elderly but can develop at any age.  There are a variety of problems that can cause this type including infection, head trauma and tumors as well as subarachnoid hemorrhage.

The symptoms of hydrocephalus differ depending on the age of the person diagnosed.  Infants less than 1 year old will have significant swelling of their head as well as bulging in the “soft spots” in their skull.  As the  fluid accumulates their head circumference increases rapidly and you will be able to see swollen veins under the skin.  Depending on how severe the hydrocephalus is they may also be irritable,  and sleepy along with vomiting as well as seizures.  In older children you may not be able to see their head enlarge because their bones are already fused together so the skull can’t expand.  This causes the pressure on the brain to be more intense causing severe headaches.  These headaches are frequently accompanied by nausea and vomiting, difficulty with balance, double vision and squinting as well as sleepiness and seizures.  In adults especially those over 60 years of age the symptoms include memory loss and increasing loss of reasoning skills, difficulty walking and poor balance and coordination.  Most also experience a frequent urge to urinate or loss of bladder control.

The most common treatment used for hydrocephalus is to surgically insert a drainage system known as a shunt.  A shunt is a flexible tube with a valve that keeps the cerebral spinal fluid moving in the right direction as well as at the proper rate.  The surgeon will place one end of the tube in one of the ventricles in the brain and thread the tube under the skin to an area of the body when the excess fluid can more easily be reabsorbed.  People that have hydrocephalus generally require this type of drainage system for their entire life and will require regular monitoring.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at