HSA Members - Log In

HSA Members - Log In

What is Hydrocephalus?

Hydrocephalus is a chronic, neurological condition where cerebrospinal fluid (CSF) accumulates and builds up in the brain.

Hydrocephalus means ‘water on the brain’ and can be present for a number of different reasons. The condition cannot be cured but it can be treated. Cerebrospinal fluid is a clear liquid that surrounds the brain and spinal cord, protecting them from injury. It carries nutrients to both the brain and spinal cord and takes away waste. In a healthy person, the amount of CSF produced by the brain is easily absorbed by the body. In a person with hydrocephalus, the fluid doesn’t drain and instead accumulates, leading to pressure on the brain. Too much pressure can damage the brain.

Fluid can build up in a person with hydrocephalus because:

  • the brain makes too much
  • there is a blockage and it cannot drain properly
  • it is not being absorbed into the bloodstream

The most common treatment is the insertion of a VP shunt, a medical device designed to drain excess fluid from the brain to another part of the body. Unfortunately, shunts are the most common to fail medical device. Read more about the different types of hydrocephalus below.

Hydrocephalus can affect your life in many ways and the degree of impact can vary. It can create medical, financial, and social challenges, and might negatively alter your ability to live independently.

By learning more about ongoing management, you’ll feel more in control and be able to make informed decisions regarding your lifestyle and medical care.

1 IN 800

One in every 800 Australian children are born with hydrocephalus each year.

50% OF SHUNTS FAIL

50% of shunts in the paediatric population fail within two years of placement.

NO GOVERNMENT FUNDING

The HSA receive no government funding. The HSA remain operational through the support of fundraisers and donations. 

Types & Causes

Congenital Hydrocephalus

Hydrocephalus that has been present since birth is referred to as congenital hydrocephalus. Read more below.

Acquired Hydrocephalus

This type of hydrocephalus develops after birth through to adulthood. Read more below.

Communicating Hydrocephalus

This type of hydrocephalus occurs when the flow of cerebrospinal fluid (CSF) is blocked after it exits the ventricles. Read more below.

Non-Communicating Hydrocephalus

This type of hydrocephalus occurs when there is an interference to the flow of CSF between the ventricles in the brain. Read more below.

Normal Pressure Hydrocephalus

This is a form of communicating hydrocephalus and appears to be most commonly developed as the brain ages. Read more below.

Types Of Hydrocephalus Explained

Your Title Goes Here

Your content goes here. Edit or remove this text inline or in the module Content settings. You can also style every aspect of this content in the module Design settings and even apply custom CSS to this text in the module Advanced settings.

CONGENITAL HYDROCEPHALUS

Congenital hydrocephalus is where hydrocephalus is present at birth. It is caused by a variety of factors, such as genetic abnormalities, infections, or brain malformations during fetal development.

Hydrocephalus that has been present since birth is referred to as congenital hydrocephalus. The causes are still being studied but are thought to be caused by a complex interaction of genetic and environmental factors during fetal development. There are likely many genes that can cause hydrocephalus or be a risk factor for increasing the likelihood of developing hydrocephalus.

The most common cause of congenital hydrocephalus is obstruction of the cerebral aqueduct — the long, narrow passageway between the third and fourth ventricle or cavity of the brain. Congenital hydrocephalus may result from a blockage, infection, hemorrhage, tumor or arachnoid cyst. It may also be caused by genetic abnormalities or developmental disorders such as aqueductal stenosis, chiari malformation, spina bifida, Dandy Walker syndrome, neural tube defects & arachnoid cysts. There are occasions where hydrocephalus is diagnosed prior to the diagnosis of an underlying medical condition.

1 in 800 babies are born with hydrocephalus every year in Australia making congenital hydrocephalus the most common type in the country.

Some signs and symptoms of congenital hydrocephalus may include:

  1. An unusually large head or a rapid increase in head circumference
  2. A bulging or tense fontanelle (the soft spot on the baby’s head)
  3. A downward gaze of the eyes or sunsetting eyes
  4. Irritability or lethargy
  5. Vomiting or nausea
  6. Seizures
  7. Delayed development or milestones

It is important to note that these symptoms may not be exclusive to congenital hydrocephalus and could indicate other conditions, so it is essential to consult a healthcare professional for an accurate diagnosis.

AQUIRED HYDROCEPHALUS

Acquired hydrocephalus is a type of hydrocephalus that develops after birth, usually as a result of an injury or a medical condition that affects the brain’s ability to regulate the production, flow, or absorption of cerebrospinal fluid (CSF).

Unlike congenital hydrocephalus, which is present at birth, acquired hydrocephalus can develop at any age.

Acquired hydrocephalus can be caused by a variety of conditions, including brain tumors, meningitis, traumatic brain injury, intracranial hemorrhage, and infections. These conditions can lead to an obstruction in the flow of CSF, a reduction in the absorption of CSF, or an overproduction of CSF, which can cause an increase in intracranial pressure and lead to the development of hydrocephalus.

This type of hydrocephalus develops after birth through to adulthood and is often a result of infection, haemorrhage, trauma to the head or as a result of a cyst or tumour developing. 

For instance, trauma to the head can affect the brain’s tissues, nerves, or blood vessels and can result in inflammation and blockages to CSF flow. CSF absorption channels may also be blocked by scarred membranes or by blood cells.

The symptoms of acquired hydrocephalus may vary depending on the underlying cause and can include:

  • headaches
  • nausea
  • vomiting
  • seizures
  • visual disturbances
  • changes in mental status

Treatment for acquired hydrocephalus typically involves addressing the underlying condition that caused the hydrocephalus, such as surgery to remove a brain tumor or antibiotics to treat an infection. In some cases, a shunt procedure may be necessary to divert the excess CSF and relieve the pressure on the brain.

COMMUNICATING HYDROCEPHALUS

Unlike non-communicating hydrocephalus, which is caused by an obstruction in the flow of CSF within the ventricles, communicating hydrocephalus involves the normal flow of CSF being blocked outside the ventricles.

Communicating hydrocephalus occurs when the flow of cerebrospinal fluid (CSF) is blocked after it exits the ventricles and is entering the subarachnoid space, which is the space between the brain and the skull. CSF normally flows unrestricted through the ventricles and into the subarachnoid space. A thickening of the arachnoid layer around the outside of the brain may prevent the free flow of CSF through this pathway. The word “communicating” refers to the fact that CSF can still flow between the ventricles, which remain open. The reabsorption of CSF can sometimes be disrupted by blockages or reduced flow of fluid, which can also result in a buildup of CSF in the ventricles.

The causes of communicating hydrocephalus can include traumatic brain injury, meningitis, subarachnoid hemorrhage, or a tumour.

 

Signs and symptoms

The symptoms of communicating hydrocephalus are similar to other types of hydrocephalus and may include:

  • headaches
  • nausea
  • vomiting
  • visual disturbances
  • changes in mental status
NON-COMMUNICATING HYDROCEPHALUS

The reabsorption of CSF can sometimes be disrupted by blockages or reduced flow of fluid, which can also result in a buildup of CSF in the ventricles.

This type of hydrocephalus is often also referred to as obstructive hydrocephalus. It occurs when there is an interference to the flow of CSF between the ventricles in the brain.

Aqueductal stenosis is one of the most common causes of non-communicating hydrocephalus. This is where there is a narrowing of the aqueduct of Sylvius, a small passage between the third and fourth ventricles in the middle of the brain.

The symptoms of communicating hydrocephalus are similar to other types of hydrocephalus and may include:

  • headaches
  • nausea
  • vomiting
  • visual disturbances
  • changes in mental status
NORMAL PRESSURE HYDROCEPHALUS

Normal pressure hydrocephalus (NPH) is a type of hydrocephalus that primarily affects older adults, typically those over the age of 60 years.

NPH is characterized by an abnormal buildup of cerebrospinal fluid (CSF) in the brain’s ventricles, leading to an increase in intracranial pressure. The condition is called “normal pressure” because the pressure inside the skull may not rise to levels typically seen in other forms of hydrocephalus. The exact cause of NPH is not fully understood, but it is thought to be associated with underlying conditions such as head injury, stroke, or bleeding in the brain.

Signs and symptoms

Normal pressure hydrocephalus (NPH) can cause a wide range of symptoms, and these can vary depending on the severity of the condition and the individual affected.

The classic triad of symptoms seen in NPH are:

  1. Gait disturbance: This is the most common symptom of NPH, and it typically involves a shuffling gait, balance problems, and difficulty initiating movements. Individuals may have difficulty walking, and their steps may become shorter and slower. They may also have a tendency to fall backward.
  2. Dementia: NPH can cause changes in cognitive function, including memory loss, difficulty concentrating, and confusion. Individuals may have difficulty with activities of daily living, and they may become forgetful or disoriented.
  3. Urinary incontinence: NPH can also cause changes in bladder function, leading to urinary frequency, urgency, and incontinence.

Other symptoms of normal pressure hydrocephalus may include headaches, nausea, vomiting, and visual changes such as double vision or blurred vision.

It is important to note that these symptoms can be caused by other conditions as well, and not all individuals with NPH will have all of these symptoms.

 Normal pressure hydrocephalus (NPH) is a form of communicating hydrocephalus and appears to be most commonly developed as the brain ages, however, it can strike people at any age.

It may be the result of a subarachnoid haemorrhage, head trauma, infection, tumor or complications of surgery. However, many people develop normal pressure hydrocephalus even when none of these factors are present for reasons that are unknown. In that case it is called idiopathic normal pressure hydrocephalus.