Hydrocephalus, often referred to as 'water on the brain', is a buildup of fluids inside the skull that leads to swelling. Cerebrospinal fluid accumulates abnormally in the brain's ventricles, or cavities, causing intracranial pressure. This leads to progressive enlargement of the head and many other symptoms, including possible death.

Symptoms of Hydrocephalus

Symptoms of hydrocephalus differ depending upon the circumstances, age of the patient, cause for the blockage and brain damage that has already occurred. Increasing pressure in the cranium can lead to headaches, nausea, vomiting or even coma. Intracranial pressure that is elevated can result in life threatening conditions. Following is a list of symptoms that may be experienced by infants or children with hydrocephalus:

  • Seizures
  • Sleepiness
  • Irritability
  • Eyes that appear to be looking downward
  • Changes in memory or ability to think clearly
  • Changes in facial appearance, including spacing between the eyes
  • Crossed eyes or eyes that experience involuntary movements
  • Loss of bladder control
  • Loss of coordination
  • Muscle spasms
  • Slow Growth

Causes of Hydrocephalus

Cerebrospinal fluid normally flows evenly around the brain and spinal cord. This fluid is responsible for bringing nutrients to the brain, removing the waste and acting as an overall barrier of protection. This fluid flows freely around the brain, through the cavities, and then is absorbed back into the bloodstream. If this even flow is interrupted, either by a blockage or by overproduction of the fluid itself, the brain's tissues can become damaged due to the pressure of the brain being pushed against the skull. There are a number of conditions that can lead to hydrocephalus:

  • Myelomeningocele, a birth defect causing incomplete closure of the spinal column
  • Genetic defects
  • Infections of the mother during pregnancy
  • Meningitis or encephalitis
  • Bleeding in the brain
  • Brain injury before, during or after birth
  • Tumors


Diagnosing hydrocephalus may begin with a notation by parents or physicians of symptoms that could indicate the condition. Veins on the scalp may appear enlarged, and when the skull is lightly tapped, abnormal sounds may indicate separation of bones in the area. If head circumference measurements show that the head is increasing abnormally in size, further tests may need to be performed. There are several tests that can help to determine the presence of hydrocephalus:

  • CT scan
  • X-rays of the skull
  • Brain ultrasound
  • Arteriography
  • Brain scan using radioisotopes


Treating hydrocephalus aims to reduce blockage of cerebrospinal fluid, allowing it to flow more freely and reduce the chances for serious brain damage. There are several ways to treat this condition, and options will likely be chosen based upon several factors. Following is a list of possible treatments to help alleviate symptoms caused by hydrocephalus:

  • Surgery - if possible, any blockages may be removed. If no blockage is present, or removal would lead to further problems, a shunt may be placed within the brain. A shunt is a flexible tube that would lead from the brain to another part of the body where the excess brain fluid could be drained and reabsorbed.
  • ETV - endoscopic third ventriculostomy is a process that helps to relieve pressure without having to replace a shunt, if one is present.
  • Cauterization - the portions of the brain which are overproducing cerebrospinal fluid may be partially burned off to reduce the amount of fluid present.
  • Ongoing examinations - necessary care is recommended throughout life to keep a close record of any changes and prevent situations which could result in decline of health or death.
  • Support services - help may be required for patients with this condition to live and work in society. Social services, local agencies, home care nurses and support groups may provide support, funding, ideas or exercises to increase well-being for a child or adult with this condition.