A baby with hydrocephalus has extra
fluid in and around the brain. This fluid is called cerebrospinal fluid (CSF). Most
is normally found in fluid-filled areas (ventricles) inside the brain. Its purpose
to cushion and protect the brain and the spinal cord.
Too much CSF can increase the
pressure in your baby’s head. This causes the bones in your baby’s skull to expand
separate. The baby's head may look larger than normal.
Hydrocephalus is rare. It may be
caused by any of these problems:
- The fluid is blocked from flowing
through your baby’s head.
- Your baby has problems absorbing the
- Your baby makes too much fluid
This condition can be congenital.
This means that your baby is born with it. Hydrocephalus can also happen later in
Causes of this condition include:
- Congenital aqueductal stenosis
(narrowing of the aqueduct)
- Neural tube defects, such as spina
- Premature birth
- Bleeding inside your baby’s brain
- Birth injuries
- Blood vessels in your baby’s head that
aren’t formed right
Symptoms can occur a bit
differently in each child and depend on age.
In babies, they may include:
- A full or bulging soft spot on the top
of your baby’s head (fontanel)
- A rapid increase in head size
- An unusually large head
- Eyes that are fixed downward ("sun
setting") or are not able to turn outward
- Visible scalp veins
- High-pitched cry
- Problems sucking or feeding
- Sleepiness or being less alert than
- Developmental delays
In older children, they can include:
- Blurred or double vision
- Nausea or vomiting
- Problems with balance
- Slowing or loss of developmental progress like walking or
- Vision problems
- Decline in school or job performance
- Poor coordination
- Loss of bladder control, frequent urination, or both
- Difficulty remaining awake or waking up
- Changes in personality or cognition including memory
The symptoms of hydrocephalus may
seem like symptoms of other conditions. Make sure your child sees their healthcare
provider for a diagnosis.
A healthcare provider may first
spot this condition in your baby during an ultrasound in pregnancy. In many cases,
hydrocephalus doesn't develop until the third trimester of the pregnancy. Ultrasounds
done earlier in pregnancy may not show this condition.
Your child may be diagnosed with
this condition after birth. Your child’s healthcare provider will examine your child
and ask you about their prenatal, birth, and family history. If your baby is older,
child’s provider may ask if they are meeting milestones. Children with this condition
may be likely to have developmental delays. If your child has a delay, their healthcare
provider may check for underlying problems.
Your baby’s head may be larger than
normal. Your child’s healthcare provider will measure their head. This measurement
called the head circumference. If your baby’s head size isn’t in the normal range
growing faster than normal, they will have tests. These tests can confirm
This test uses sound waves to
create an image of the inside of the body. During pregnancy, this test can show the
size of the ventricles inside of your baby’s head. It can also be used after birth
while the anterior fontanelle remains open.
This test uses large magnets,
radio waves, and a computer. Together, these show detailed images of organs and
structures inside your baby’s body.
This test uses X-rays and
computer technology to make detailed images of any part of your baby’s body. These
include bones, muscles, fat, and organs. CT scans are more detailed than X-rays.
Treatment will depend on your
child’s symptoms, age, and general health. It will also depend on how severe the
The goal of treatment is to reduce
the pressure inside your baby's head. This can be done by draining the fluid. Your
may need medicine to remove the extra fluid. Some children need surgery.
In surgery, a healthcare
provider usually places a mechanical shunting device in your baby’s head. This helps
drain the fluid from your baby’s brain. The fluid is directed to another part of your
baby’s body, where it can be absorbed.
The shunt usually runs behind your
baby’s ear. The tubing goes under your baby’s skin to the belly (abdomen), heart,
lung. Your baby's healthcare provider will decide the drainage location. This will
based on your baby’s condition, age, and other factors. The belly is generally the
choice. A VP (ventriculoperitoneal) shunt is often used to direct fluid into the
What are possible complications from the shunts or surgery
for hydrocephalus in a child?
Sometimes surgery and shunts can
cause problems. Possible complications include:
- A shunt that doesn’t work, and may
drain too much or not enough fluid
After surgery, your child’s
healthcare team will tell you how to care for your baby at home. They’ll also tell
you symptoms that are an emergency. If your child has these symptoms, call their
healthcare provider right away.
You can't prevent hydrocephalus in your child. But your baby’s
healthcare provider may suggest genetic counseling if you plan to have more children.
Through counseling, you can learn about the risk for this condition in future
pregnancies. You may also need testing during pregnancy to check for hydrocephalus.
Hydrocephalus can affect your
baby’s brain and development. Your child’s outlook depends on how severe the condition
is. It also depends on other brain and health problems your baby has.
The key to treating this condition
is getting it diagnosed and treated early, and preventing infections. Your baby will
need regular checkups to make sure their shunt is working right. Your child’s healthcare
team will work closely with you as your baby grows.
When to Call a Healthcare Provider
The key to treating this condition
is getting it diagnosed and treated early, and preventing infections. If your child
a shunt, they will need regular checkups to make sure their shunt is working right.
child’s healthcare team will work closely with you as your child grows. Ask your child's
healthcare provider for symptoms to look out for and when and where to get medical
Some symptoms of shunt malfunction that need immediate medical help include:
- Nausea or vomiting
- Change in behavior or mental status
- Increased sleepiness or exhaustion
- Redness or tenderness along the shunt track
- Double vision of sensitivity to light
- Soreness of the neck or shoulder muscles
- Recurrence of hydrocephalus symptoms
- Eyes that are fixed downward ("sun setting") or are not able to
- A baby with hydrocephalus has extra
cerebrospinal fluid (CSF) around the brain. The baby's head may look larger than
- This is a rare condition.
- A healthcare provider may diagnose
this condition during an ultrasound in pregnancy.
- The goal of treatment is to reduce the
pressure inside your baby's head. This is done by draining the fluid or decreasing
- The key to treating this condition is
getting it diagnosed and treated early, and preventing infections.
Tips to help you get the most from
a visit to your child’s healthcare provider:
- Know the reason for the visit and what
you want to happen.
- Before your visit, write down
questions you want answered.
- At the visit, write down the name of a
new diagnosis, and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment
is prescribed and how it will help your child. Also know what the side effects
- Ask if your child’s condition can be
treated in other ways.
- Know why a test or procedure is
recommended and what the results could mean.
- Know what to expect if your child does
not take the medicine or have the test or procedure.
- If your child has a follow-up
appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s
healthcare provider after office hours. This is important if your child becomes ill
and you have questions or need advice.