Acquired Hydrocephalus

Signs and Symptoms

Acquired hydrocephalus is caused by conditions that develop after birth, such as a hemorrhage, meningitis, head trauma, tumors and cysts.

Symptoms in older children may include:

• Headache
• Nausea with or without vomiting
• Papilledema or the swelling of the optic disk, which is part of the optic nerve
• Blurred vision
• Double vision
• Downward deviation of the eyes
• Problems with balance
• Poor coordination
• Awkward gait
• Incontinence
• Slowed development
• Drowsiness or lethargy
• Irritability
• Memory loss
• Other changes in personality or cognition

Diagnosis

During your child's visit at UCSF Children's Hospital, our doctors and other staff members will thoroughly evaluate your child. Our staff will ask you about the medical history of your child as well as of your immediate family. If your pediatrician has sent us your child's medical records, we will review this information. Be sure to tell your doctors about any medications your child is currently using, including over-the-counter medications, vitamins, nutritional supplements or herbal remedies.

Because several problems such as infections and tumors can lead to hydocephalus, the first step is to determine the underlying cause. Hydrocephalus is assessed by measuring its effect upon the brain. If cerebrospinal fluid (CSF) builds up, it frequently leads to enlarged cavities visible on a computer tomography (CT) scan of the head.

Your child's evaluation will include imaging techniques such as ultrasonography, computer tomography (CT), magnetic resonance imaging (MRI) or pressure-monitoring techniques.

Measurement of pressure within the skull is sometimes required before determining treatment. This measurement is made by placing a small monitor beneath the skull during a short surgical procedure.

Treatment

Acquired hydrocephalus is most commonly treated by either removing the cause of the condition, such as a tumor or other blockage, or inserting a shunt. The shunt is a flexible plastic tube that diverts excess cerebrospinal fluid (CSF) from the brain to the abdomen where it can be absorbed back into the body. A valve within the shunt regulates and prevents excessive drainage.

A limited number of patients can be treated with an alternative procedure called endoscopic third ventriculostomy (ETV). In this procedure, a small hole is made in the floor of the third ventricle of the brain, allowing the cerebrospinal fluid to bypass the obstruction and flow toward an area where it can be reabsorbed by the body. 

Your medical team will explain any possible risks or complications from these treatments. Your child may need more than one kind of treatment, or treatment requiring several visits to UCSF Children's Hospital. You and your child may be referred to additional doctors or other medical professionals.

Hydrocephalus can pose risks to both mental and physical development. Many children diagnosed with this disorder benefit from rehabilitation and educational programs, and go on to lead normal lives.

Don't be afraid to ask your doctors, nurses or therapists about the treatments. If treatment includes medication, be sure that your child takes it exactly as your doctor has ordered. And remember to bring your child to all follow-up appointments.