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Who is at Greatest Risk for Developing Hydrocephalus?

The term hydrocephalus is derived from a combination of two Greek words: hydro, meaning water, and cephalus, meaning head. Although this literally translates to “water on the brain,” hydrocephalus actually refers to the abnormal and dangerous buildup of cerebrospinal fluid (CSF) within the brain. 

Normally, CSF cushions and protects the brain. But with hydrocephalus, this vital fluid accumulates in the cavities (ventricles) deep within the brain, forcing them to expand and exerting harmful pressure on the brain.    

Here, board-certified neurosurgeon and hydrocephalus specialist Adam Lewis, MD discusses what’s behind this dangerous medical problem, who has the greatest risk of developing it, and how he treats it at Jackson Neurosurgery Clinic in Flowood, Mississippi. 

Understanding hydrocephalus

CSF is the clear, watery body fluid that shields the brain and spine. Produced in the brain’s ventricles and choroid plexus, this critical protective liquid normally flows through the ventricles and bathes the brain and spinal cord before being reabsorbed into the bloodstream.   

 Usually, the brain produces just enough CSF each day to meet its needs, and the body reabsorbs that same amount. When the flow or absorption of CSF is blocked, or when the brain produces too much CSF, the fluid builds up inside the ventricles and causes them to widen, exerting pressure on the brain.

Simply put, hydrocephalus is an imbalance between how much CSF is produced and how much is reabsorbed into the bloodstream. The internal pressure caused by too much CSF can damage brain tissues, impair brain function, and, if left untreated, even be fatal. 

Who does hydrocephalus affect? 

Hydrocephalus affects more than 1 million people in the United States. While anyone can develop it at any age — the condition occurs in newborns, toddlers, and older children as well as adolescents and adults — most cases are concentrated in two specific groups: infants and adults aged 60 and older. 

Although infants and older adults carry the highest risk of developing hydrocephalus, each of these age groups is affected by a different “type” of the condition and experiences a different set of symptoms. 

Congenital hydrocephalus

Hydrocephalus that’s present at birth is called congenital hydrocephalus. This form of the condition is thought to be the result of a complex interaction of genetic and environmental factors during fetal development.

Congenital hydrocephalus can be the result of a brain malformation that restricts the flow of CSF, or it may be the product of a health condition like spina bifida, aqueductal stenosis, or arachnoid cysts. In many cases, the cause of congenital hydrocephalus is unknown.  

Signs of congenital hydrocephalus in newborns include:

  • Obvious changes in the head
  • An unusually large head
  • A rapid increase in head size
  • A bulging or tense soft spot (fontanel) 

These signs are often accompanied by other physical symptoms like sleepiness, sluggishness (lethargy), irritability, and poor eating; babies with congenital hydrocephalus may also have eyes that are fixed downward (sunsetting of the eyes) or experience seizures. 

Hydrocephalus that develops in later infancy or early childhood, but is caused by a condition that existed at birth, is still considered a form of congenital hydrocephalus. 

 Acquired hydrocephalus

Hydrocephalus that develops after birth (and isn’t related to a health condition that existed at birth) is known as acquired hydrocephalus. This form of the disorder can affect children and adults of all ages; most cases emerge following an injury or an illness.    

Common causes of acquired hydrocephalus include traumatic brain injuries, lesions or tumors of the brain or spinal cord, central nervous system infections such as meningitis, and bleeding in the brain from a stroke. 

There are various classifications of acquired hydrocephalus. Normal pressure hydrocephalus (NPH) is the type that most commonly affects adults aged 60 and older. NPH occurs when a buildup of CSF causes the ventricles in the brain to enlarge, but doesn’t cause a considerable increase in the pressure within the ventricles. 

Common signs of NPH in older adults include:

  • Poor coordination or balance; difficulty walking
  • Loss of bladder control; frequent urge to urinate
  • Memory loss; progressive loss of reasoning skills

Given that mobility problems, urinary incontinence, and memory loss are the main symptoms of NPH as well as other common age-related illnesses like dementia and Alzheimer’s disease, NPH isn’t always suspected, diagnosed, and treated as early as it should be. 

Hydrocephalus is treatable

Given that hydrocephalus can damage brain tissue, impair brain function, and eventually lead to death, timely diagnosis and treatment is of utmost importance. The good news is that there are surgical solutions that can restore normal levels of CSF. 

Depending on the underlying cause of hydrocephalus, the condition may be treated directly by removing the cause of CSF obstruction, or indirectly by diverting the excess fluid. 

In most cases, it’s treated indirectly by implanting a device known as a “shunt” to divert the excess CSF away from the brain to another area of the body where it can be absorbed. Once inserted, a shunt system usually remains in place for life. 

To schedule a visit with Dr. Lewis or learn more about the hydrocephalus treatment options available at Jackson Neurosurgery Clinic in Flowood, Mississippi, call 601-436-3963 today.