Congenital Hydrocephalus

Accumulation of cerebrospinal fluid in the ventricles or chambers in the brain, leads to hydrocephalus which results in the enlargement of the head, and the impairment of the normal growth and development of the brain.

  • Hydrocephalus results from the lack of drainage of the cerebrospinal fluid in the ventricles of the brain.
  • Enlargement of the head, and impairment of mental and intellectual development of the baby, are the usual symptoms.
  • An ultrasound scan, CT scan, or magnetic resonance imaging can help determine the severity of the condition.
  • Surgical insertion of a shunt which drains the excess fluid out of the brain is often required.

The cerebrospinal fluid which surrounds the brain is produced in the ventricles of the brain. The fluid normally drains from the brain to another area where the blood absorbs it. When the drainage is not proper, the fluid accumulates in the brain, resulting in hydrocephalus, which is commonly referred to as ‘water in the brain’. The excess fluid leads to pressure build up and compression of the brain. The cerebrospinal fluid drainage may be prevented due to various reasons. Congenital defects, brain tumors, or brain hemorrhage in infants, especially in prematurely born babies, may impede proper drainage of the fluid.

When congenital hydrocephalus is not treated, the infant’s development may suffer, and the head may remain very large. The extent and severity of brain compression due to hydrocephalus can be determined by an ultrasound scan or a CT scan. Magnetic resonance imaging of the head can also help in accurate diagnosis.

The pressure inside the brain is kept normal by various treatment procedures. A lumbar puncture can relieve the pressure temporarily, but a shunt can open up a permanent drainage for the excess cerebrospinal fluid accumulating in the brain, thus keeping the pressure within limits. In a ventriculoperitoneal shunt, the fluid from the ventricles of the brain is shunted via a tube which runs under the skin to the abdominal lining. A valve in the shunt regulates the pressure in the ventricles by channeling the excess volume of fluid away from the brain. The shunt is often left in place even after the child outgrows the need for it later on in life. Ventriculostomy is another surgical procedure, in which a hole is made between the third ventricle and the fourth one, which is often helpful in treating hydrocephalus in certain cases.

Lumbar punctures are often done to reduce the pressure in the brain till a permanent shunt can be fixed surgically to regulate the pressure.

Reduced mental development and learning difficulties occur in many children who have congenital hydrocephalus, especially when the condition had developed early in the fetus. When this condition develops later in pregnancy, the associated symptoms are less severe. Some children with hydrocephaly may have normal levels of intelligence.

Watch This Explanatory Video About Hydrocephalus

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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