|Hydrocephalus is a condition that causes an enlargement of the ventricles inside the brain because of a build up of cerebrospinal fluid (CSF), which can lead to raised intracranial pressure. This can either be from the fluid not being absorbed properly (nonobstructive or communicating hydrocephalus) or because there is a blockage to the flow of CSF (obstructive or noncommunicating hydrocephalus). It can also rarely be caused by an increased production of CSF by a choriod plexus papilloma.
Among the symptoms that a child with hydrocephalus may have include headache, lethargy or decreased activity, vomiting, irritability, vision problems, and abnormalities of the pupils and muscles of the eye.
The most common symptom in infants is a rapidly accelerating rate of growth of the head (leading to macrocephaly or a large head size), and a fontanel that is wide open and bulging. They may also have a downward deviation of their eyes (setting sun sign)
It is important to keep in mind that many children with a large head size are normal, especially if they are otherwise doing well. Your Pediatrician may just watch the growth of his head and plot his FOC (head circumference) on a growth curve to make sure that it is growing normally and not faster than expected. It is more concerning for a head size that is growing at a rate that is faster than expected or which has crossed more than 2 percentile lines.
Among the tests that can be done to check for hydrocephalus include a head ultrasound for younger children who still have an open fontanel or a magnetic resonance imaging (MRI) of the brain.
There are many diseases and conditions that can cause hydrocephalus, including brain tumors, meningitis, trauma, brain cysts, spina bifida, degenerative disorders, such as histiocytosis X, and vascular malformations. It can also be congenital (your child is born with it), from aqueductal stenosis (having a narrow aqueduct of Sylvius, through which CSF normally flows), Chiari malformations, Dandy-Walker syndrome, and after having an intraventricular hemorrhage in premature infants.
Treatments depend on the cause, but usually include placement of an extracranial shunt by a Pediatric Neurosurgeon to help drain the excess CSF. A common type of shunt is the ventriculoperitoneal shunt (VP shunt) that drains fluid from the ventricles into the peritoneal cavity of the abdomen. Sometimes medications, including acetazolamide and furosemide, may be used to try and decrease the rate of production of CSF, but this usually doesn't work very well.
Hydrocephalus Internet Resources:
- Hydrocephalus in Children: Hydrocephalus causes an excessive accumulation of fluid in the brain, which can cause the ventricles to enlarge. Learn about the different types of hydrocephalus, causes, symptoms, diagnosis, testing and treatments.
- Hydrocephalus Links: Find resources, support groups and discussion lists to get more information about your child with hydrocephalus.