Hydrocephalus

The symptoms in adults can vary depending on the type of hydrocephalus. Symptoms include: 

Hydrocephalus that develops in adults (acquired hydrocephalus)

• Headaches - worse in the morning as fluid may have built up overnight. Headaches may become continuous
• Nausea or being sick – this may be worse in the morning
• Sleepiness – can progress to a coma
• Changes in mental state, such as confusion
• Blurred vision or double vision
• Difficulty walking
• An inability to control the bladder (urinary incontinence) or bowel (bowel incontinence)

Normal pressure hydrocephalus (NPH)

The symptoms tend to affect older people and usually develop slowly, over a period of many months or years.

• Affects on your gait, mobility and how you walk. This is the most noticeable symptom and it may be increasingly difficult to take the first step when walking, you may be prone to falling or shuffling your feet
• Affects on your bladder and the urinary system including incontinence
• Affects on your mental abilities. You may become slow in responding to questions, react more slowly to situations or be slow to process information

Your consultant will discuss your symptoms with you to help make a diagnosis. They may carry out a physical neurological examination and order imaging tests. Tests may include an MRI and/or CT scans which can detect enlarged ventricles (interconnected cavities in the brain that produce fluid).

Once diagnosed your consultant will discuss the treatment options available.

The most common treatment for hydrocephalus is a shunt, a drainage system, where a tube is inserted into one of the ventricles and used to drain excess fluid from the brain. The other end of the tube is then inserted into another area of the body, such as the stomach, where the fluid can be absorbed. 

The symptoms in children can vary depending on the type of hydrocephalus. Symptoms include:

Hydrocephalus from birth (congenital hydrocephalus)

• an unusually enlarged head
• downward looking eyes
• a bulging fontanelle (soft spot on top of a baby's head)
• a taut and shiny scalp with visible veins
• Other symptoms for babies can also include trouble feeding and sleeping, and spasms in the legs.

Hydrocephalus that develops in children (acquired hydrocephalus)

• Headaches - worse in the morning as fluid may have built up overnight. Headaches may become continuous
• Feeling sick or being sick – this may be worse in the morning
• Sleepiness – can progress to a coma
• Changes in mental state, such as confusion
• Blurred vision or double vision
• Difficulty walking
• An inability to control the bladder (urinary incontinence) or bowel (bowel incontinence)

Your consultant will discuss your childs symptoms with you to help make a diagnosis. They may carry out a physical neurological examination and order imaging tests. Tests may include:

• Ultrasound scan a low-risk scan that may be used to detect hydrocephalus in babies. It can also detect the condition in the womb.
• MRI and CT scans which can detect enlarged ventricles (interconnected cavities in the brain that produce fluid).

Once diagnosed your consultant will discuss the treatment options available.

The most common treatment for hydrocephalus is a shunt. This is a drainage system, where a tube is inserted into one of the ventricles (a chamber which produces the cerebrospinal fluid) and used to drain excess fluid from the brain. The other end of the tube is inserted into another area of the body, such as the stomach, where the fluid can be absorbed. 

A procedure called an endoscopic third ventriculostomy is another option, particularly in children. Guided by a camera, a surgeon will make a small hole in a thinned area of the third ventricle so that the fluid can exit the brain to be absorbed in the usual way without the need for a shunt.