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UK pediatric neurosurgeon answers your questions about hydrocephalus

Dr. Brandon Miller

/ by UK HealthCare

You’ve just found out that your newborn baby has hydrocephalus, and you probably have a lot of questions. Will my child lag behind in school? Could this lead to more health problems? Is this fatal?

The good news is that hydrocephalus is treatable.

“When hydrocephalus is effectively treated, children can live a very normal life,” said Dr. Brandon Miller, a pediatric neurosurgeon at UK HealthCare. Dr. Miller also directs a lab that studies hydrocephalus and intraventricular hemorrhage, which is one of the causes of hydrocephalus. He is interested in how hydrocephalus causes inflammation in the brain and how non-surgical treatments can help patients with intraventricular hemorrhage and hydrocephalus.  

Here’s what you should know about hydrocephalus and how the condition is treated:

What is hydrocephalus?

Hydrocephalus is the buildup of excess cerebrospinal fluid (CSF) within the brain. The pressure from the fluid buildup may lead to brain injury if the condition is not treated.

Normally, CSF flows through and out of chambers in the brain (called ventricles) and then around the brain and spinal cord, providing a protective cushion around the brain. Hydrocephalus is caused by an imbalance between the brain's production of CSF and the body's ability to distribute or absorb it properly.

What are the symptoms?

The clearest symptom of hydrocephalus is a head that is larger than normal. You and your doctor may notice it when your baby is born or within the first several months of life. It's normal for a baby's head to grow a lot during the first year. But with congenital hydrocephalus, the head may grow faster than the normal rate for a baby's height and weight.

The condition may cause the soft spot (fontanelle) on your baby's head to feel firm or bulge out. The areas between the skull bones (sutures) may be larger than normal, too.

If pressure builds in the brain, your baby may:

  • Be irritable.
  • Sleep too much.
  • Vomit.
  • Eat very little.

When does it occur?

Hydrocephalus often presents at birth (congenital) and is usually noticeable within the first nine months of life. It may also be a consequence of intraventricular hemorrhage, which can occur in children who are born premature. Less often, hydrocephalus develops after a serious illness, such as meningitis, or a head injury.

How is it diagnosed?

A fetal ultrasound can sometimes show the problem before birth. But most cases are found during a physical exam soon after birth. Your doctor may suspect that your baby has congenital hydrocephalus if your baby's head is larger than normal.

Your baby may need imaging tests, such as a CT scan, an MRI or an ultrasound, that can give a picture of the brain with more detail. Genetic tests may be done in some cases.

How is it treated?

Early treatment for your newborn will help to protect their brain from long-term damage.

The goal of treatment is to lower the pressure on the brain by getting rid of the extra fluid. There are two common ways to do that:

  • Your doctor may place a flexible tube, called a shunt, in your baby’s brain. The shunt carries the extra fluid away from the brain to another part of your baby’s body, such as the belly or heart. Your baby’s body can absorb the extra fluid without harm.
  • Your doctor may perform a surgery called an endoscopic third ventriculostomy (ETV). In ETV, your doctor makes a small hole in membrane at the base of the patient’s brain. The hole allows the extra fluid to flow out of the brain and into the body, where it can be absorbed.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.

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