Hydrocephalus

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Skull of a newborn

Water on the brain

The goal of treatment is to reduce or prevent brain damage by improving the flow of CSF.

Surgery is the main treatment. The blockage may be surgically removed, if possible. If the blockage cannot be removed, a shunt may be placed within the brain to allow CSF to flow around the blocked area.

Alternatively, a shunt may be placed outside the brain, in an area such as the right chamber of the heart or the abdominal peritoneum.

Removing or burning away (cauterizing) the parts of the brain that produce CSF may reduce CSF production.

An important complication of shunt placement is blockage. Symptoms of such a blockage include headache and vomiting. Surgeons may be able to help the shunt open without having to replace it.

Antibiotics are given if there are sign of infection. Severe infections may require the shunt to be removed.

Another option is endoscopic third ventriculostomy (ETV), which relieves pressure without replacing the shunt.

Follow-up examinations generally continue throughout the child's life. These are done to check the child's developmental level and to treat any intellectual, neurologic, or physical problems.

Visiting nurses, social services, support groups, and local agencies can provide emotional support and assist with the care of a child with hydrocephalus who has significant brain damage.

Untreated hydrocephalus has a 50-60% death rate, with the survivors having varying degrees of intellectual, physical, and neurologic disabilities.

The outlook for treated hydrocephalus depends on the cause. Hydrocephalus that is caused by disorders not associated with infection has the best outlook. Persons with hydrocephalus caused by tumors usually do very poorly.

More than 80% of children with hydrocephalus that survive for 1 year will have a fairly normal life span. Approximately a third will have normal intellectual function, but neurological difficulties may persist.

• Problems with the shunt, such as kinking, blockage, or tube separation
• Infection
  • Meningitis
  • Encephalitis
  • Infection in the area of the shunt
• Intellectual impairment
• Neurologic damage (decrease in movement, sensation, function)
• Physical disabilities
• Complications of surgery