Hydrocephalus

At a Glance

Hydrocephalus is a condition in which cerebrospinal fluid builds up abnormally inside the brain, which can increase pressure on the brain.

Representative symptoms may include headache, nausea and vomiting, blurred vision, balance disorders, bladder control problems, and changes in thinking and memory.

How the Disease Works

Congenital hydrocephalus may be related to genetic problems or abnormalities in fetal brain development, while acquired hydrocephalus can occur following head injury, stroke, infection, tumor, or cerebral hemorrhage.

When the balance of production, circulation, and absorption of cerebrospinal fluid is disrupted, fluid accumulates, which can cause the ventricles to enlarge or brain tissue to be compressed.

Patterns Vary by Person

The patterns vary depending on the timing of onset and the cause; in congenital hydrocephalus, the head may become abnormally large, while acquired hydrocephalus can appear at any age.

Broad framework of diagnosis and management

Since untreated hydrocephalus can lead to brain damage or developmental issues, evaluation and treatment are important, and the degree of function and quality of life after treatment varies from person to person.

Diagnosis is performed by evaluating symptoms, medical history, and neurological examination together, and using imaging tests such as brain ultrasound, CT, and MRI to check the condition of the ventricles and possible causes.

Current stage of treatment

Even if the ventricles appear enlarged on imaging, hydrocephalus or the need for treatment cannot be confirmed by that alone; therefore, symptoms, age, cause, and changes over time must be interpreted together.

Management may include evaluation of the cause and cerebrospinal fluid flow, surgery when necessary, monitoring the status of drainage devices, and observation of rehabilitation therapy and functional changes.

The centerpiece of treatment is surgery to insert a shunt when necessary to divert cerebrospinal fluid to another part of the body for absorption.

How to read clinical trials

While there are registered records of studies observing quantitative pupillometry in hydrocephalus, the registration of a study alone cannot determine the effectiveness or standard of care of that method.

Points to verify in clinical encounters

In clinical practice, it is important to assess symptom onset and changes, prior imaging studies, history of surgery and shunt placement, potential for infection, hemorrhage, or injury, current functional goals, and sudden headache, recurrent vomiting, or changes in consciousness or vision.