("Water on the Brain")
Hydrocephalus is a condition in which too much fluid builds up in the brain. The fluid is called cerebrospinal fluid (CSF). It is a clear liquid that normally surrounds both the spinal cord and the brain.
Hydrocephalus occurs when:
- An excess of CSF is produced (rare)
- A blockage that doesn't allow CSF to drain properly (more commonly)
Hydrocephalus can be:
- Congenital—you are born with the condition
- Acquired—you suffer an injury or an illness that causes the condition to develop
- Brain tumors]]>
- Cancer in the cerebrospinal fluid (CSF)
- Inflammation in the CSF (such as ]]>sarcoidosis]]>)
- Cysts in the brain
- Malformations of the brain, such as:
- Brain injuries
- Infections of the brain or the meninges can be caused by a number of agents including bacteria, mycobacteria, fungus, viruses, and parasites, such as:
- Blood vessel abnormalities in the brain
- Bleeding into the brain
Risk factors for hydrocephalus include:
Symptoms depend on the severity of the hydrocephalus. The CSF puts pressure on structures within the brain. Symptoms may start out mild and become more severe as CSF pressure increases.
Symptoms may include:
- Headache (often worse when lying down or upon first awakening in the morning)
- Nausea / Vomiting
- Problems with balance
- Difficulty walking
- Poor coordination
- Personality changes
- Memory problems
- ]]>Dementia]]> in the elderly
- ]]>Coma]]> and death
- Slow development
- Loss of developmental milestones
- Bulging fontanelle (soft spot on the head)
- Large head circumference
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
Treatment may include:
- Shunt placement (ventriculoperitoneal shunt)—a shunt (a tube placed into the brain) allows excess CSF to drain into another area, usually the abdomen. Sometimes a temporary extraventricular drain (EVD) is placed.
- Third ventriculostomy—a hole is created in an area of the brain. It allows the CSF to flow out of the area where it is building up.
- Removal of the obstruction of CSF flow. For example: removal of tumor or cyst
- Lumbar puncture (spinal tap)—This involves the insertion of a needle between the back bones in the back to remove excess CSF.
- Medicines—In some cases, medicines, such as acetazolamide]]> (Diamox) and ]]>furosemide]]> (Lasix), may decrease the production of CSF.
- Other medicines such as steroids or ]]>mannitol]]> may decrease swelling around lesions which are causing obstruction of CSF flow.
Shunt to Drain Fluid From the Brain
If you are diagnosed with hydrocephalus, follow your doctor's instructions.
There are no known ways to prevent all cases of hydrocephalus. In general:
- Get regular prenatal care.
- Protect yourself or your child from head injuries.
- Keep your child’s vaccines]]> up to date.
Preliminary research suggests that some cases due to brain bleeding in the newborn period may be preventable. Cytomegalovirus or toxoplasmosis acquired by a mother during pregnancy may be a cause of hydrocephalus in a newborn baby. Mothers may reduce their risk of being infected with toxoplasmosis with these steps:
- Carefully cook meat and vegetables.
- Correctly clean contaminated knives and cutting surfaces.
- Avoid handling cat litter, or wear gloves when cleaning the litter box.
Pet rodents (mice, rats, hamsters) often carry a virus called lymphocytic choriomeningitis virus (LCV). LCV infection acquired from pets during pregnancy can lead to hydrocephalus. This is preventable by avoiding rodent contact.
Infection with ]]>chickenpox]]> or ]]>mumps]]> during or immediately after pregnancy may also lead to hydrocephalus in the baby. Both of these infections can be prevented with vaccination. Other preventable infections may also cause hydrocephalus. People who have risk factors for hydrocephalus should be carefully monitored. Immediate treatment might prevent long-term complications.
American Neurological Association
Hydrocephalus Foundation, Inc.
National Institute for Neurological Disorders and Stroke
Spina Bifida and Hydrocephalus Association of Canada
Goetz CG. Textbook of Clinical Neurology. 3rd ed. Philadelphia, PA: WB Saunders Company; 2007.
Hydrocephalus. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00393. Accessed July 1, 2009.
Kliegman R, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: WB Saunders Company; 2007.
Last reviewed October 2009 by ]]>Rimas Lukas, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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