What is Hydrocephalus

Hydrocephalus is a condition where cerebrospinal fluid (CSF), the fluid that surrounds and protects the brain and spinal cord, builds up inside the brain. This can increase pressure on the brain and cause a variety of symptoms.

Hydrocephalus can develop in children or adults and may occur for different reasons.



What Causes Hydrocephalus

Hydrocephalus occurs when the normal flow or absorption of CSF is blocked or disrupted. Common causes include:

  • Congenital causes – present at birth due to developmental abnormalities

  • Bleeding in the brain – such as from trauma, subarachnoid haemorrhage, or intraventricular haemorrhage in newborns

  • Infections – such as meningitis

  • Tumours or cysts – that block the flow of CSF

  • Normal pressure hydrocephalus (NPH) – usually in older adults, where fluid accumulates slowly


How Is Hydrocephalus Diagnosed?

Symptoms can vary depending on age and the speed of fluid buildup:

In infants and children:

  • Enlarged head size or bulging fontanelle

  • Vomiting or poor feeding

  • Sleepiness or irritability

  • Developmental delays

In adults:

  • Headaches

  • Nausea or vomiting

  • Balance problems or difficulty walking

  • Urinary incontinence

  • Cognitive difficulties or memory problems

Investigations:

  • CT scan or MRI scan of the brain to see fluid buildup


How is Hydrocephalus Treated?

Treatment aims to reduce pressure on the brain and restore normal CSF flow. Options include:

  • Ventriculoperitoneal (VP) shunt – A tube (shunt) is placed in the brain to drain excess fluid into the abdomen

  • Endoscopic third ventriculostomy (ETV) – A small hole is made in the floor of the brain’s ventricles to allow fluid to bypass the blockage

The choice of treatment depends on the patient’s age, cause of hydrocephalus, and overall health.


What is the outlook?

With early diagnosis and treatment, many patients experience good improvement.

Long-term outcomes depend on:

  • The underlying cause of hydrocephalus

  • How quickly treatment is given

  • Any associated brain injury or complications

Ongoing monitoring and follow-up with the neurosurgery team are essential to ensure shunts or procedures continue to work properly.

An extradural haematoma is a collection of blood that forms between the skull and the outer covering of the brain, called the dura. This space normally does not exist, but bleeding after a head injury can cause it to open and fill with blood.