Frequently Asked Questions about Hydrocephalus

Q. What is Hydrocephalus?
Q. What causes Hydrocephalus?
Q. Where is the best place for me to find a doctor who can help me with Hydrocephalus?
Q. How is Hydrocephalus treated?
Q. Is there a non-surgical treatment for Hydrocephalus?
Q. What is a shunt?
Q. What is ETV?
Q. What questions should I ask my doctor?
Q. What is the purpose of a second opinion? Is it important?
Q. I am pregnant and my unborn child was just diagnosed with Hydrocephalus, what should I do next?
Q. What is Hydrocephalus?
A. Hydrocephalus comes from Greek words: hydro means water, cephalus means head. Hydrocephalus is an abnormal accumulation of fluid—cerebrospinal fluid, or CSF—within cavities called ventricles inside the brain. This condition may occur at any age. CSF is produced in the ventricles, circulates through the ventricular system in the brain and is absorbed into the bloodstream. CSF is in constant circulation and has many functions. It surrounds the brain and spinal cord and acts as a protective cushion against injury. CSF contains nutrients and proteins that are needed for the nourishment and normal function of the brain. It carries waste products away from surrounding tissues. Hydrocephalus occurs when there is an imbalance between the amount of CSF that is produced and the rate at which it is absorbed. As the CSF builds up, it causes the ventricles to enlarge and the pressure inside the head to increase.
Q. What causes Hydrocephalus?
A. Hydrocephalus is a condition that can develop for a variety of reasons, sometimes in conjunction with another disorder. Hydrocephalus that is congenital (present at birth) is thought to be caused by a complex interaction of genetic and environmental factors. Aqueductal stenosis, an obstruction of the cerebral aqueduct, is the most frequent cause of congenital hydrocephalus. Hydrocephalus is believed to occur in about 1.5 per 1,000 births. Hydrocephalus that is acquired after birth may result from intraventricular hemorrhage, meningitis, head trauma, tumors or cysts or for no known reason. Hydrocephalus is believed to occur in about 1.5 per 1,000 births. Normal Pressure Hydrocephalus (NPH) is a form of hydrocephalus that affects older adults. Sometimes the cause of NPH is known-and can include head trauma or brain tumor—but most often it is idiopathic, which means the cause is not known.
Q. Where is the best place for me to find a doctor who can help me with Hydrocephalus?
A. Check out our Physician’s Directory!
Q. How is Hydrocephalus treated?
A. There is no known way to prevent or cure hydrocephalus. To date, the most common treatment is surgical insertion of a shunt. A shunt is a flexible tube placed into the ventricular system of the brain which diverts the flow of CSF into another region of the body, most often the abdominal cavity, where it can be absorbed. A valve within the shunt regulates the flow of CSF. The shunt procedure is performed by a neurosurgeon. Shunts can become clogged or malfunction and surgical revisions are often required. Endoscopic Third Ventriculostomy (ETV) is a procedure in which a small perforation is made in the thinned floor of the third ventricle, allowing movement of CSF out of the blocked ventricular system. It is a promising technique that can treat hydrocephalus without a shunt. ETV is not a cure for hydrocephalus and it is not an appropriate choice of treatment for many types of hydrocephalus. Each case must be evaluated individually by experienced medical professionals.
Q. Is there a non-surgical treatment for Hydrocephalus?
A. No. There are no known treatments other than surgical shunt placement and/or ETV. The Association is committed to the advancement of research to find alternative treatments and, one day, a cure.
Q. What is a shunt?
A. A shunt is a surgically implanted device that diverts cerebrospinal fluid (CSF) in a controlled manner from fluid compartments in the brain or near the spine to another part of the body, such as the abdomen or the heart. For nearly half a century, hydrocephalus has been treated by surgical placement of a (CSF) diverting shunt. Shunts typically consist of three components: 1. An inflow (proximal) catheter, which drains CSF from the ventricles or the lumbar subarachnoid space, to a valve; 2. A valve mechanism, which regulates differential pressure or controls flow through the shunt tubing; 3. An outflow (distal) catheter, which directs CSF from the valve to the peritoneum, heart or other suitable drainage site. Other shunt components may include reservoirs and/or antechambers for sampling or injecting medications; or dyes, on/off devices, anti-siphon or other flow-compensating devices, auxiliary catheters, etc., to modify performance or adapt the basic system to the patient’s specialized needs. In selected cases (such as when extraventricular fluid collections are drained), a shunt may not contain a valve.
Q. What is ETV?
A. Endoscopic Third Ventriculostomy is a surgical procedure in which a small perforation is made in the floor of the third ventricle, allowing movement of cerebrospinal fluid (CSF) out of the blocked ventricular system and into the interpenduncular cistern (a normal CSF space). This procedure creates a pathway to bypass an obstruction in the aqueduct of Sylvius and thereby relieve CSF pressure. The objective of this procedure is to normalize pressure on the brain without using a shunt. Endoscopic third ventriculostomy is not a cure for hydrocephalus, but rather an alternate treatment.
Q. What questions should I ask my doctor?
A. Creating and maintaining a good relationship with qualified doctors is one of the most important elements of overall healthcare planning. Some people feel nervous when speaking with a doctor-especially a neurosurgeon. It is important, however, to find out about the doctor’s experience and whether there is a good “fit” between the doctor and your family before entrusting him or her with your care or the care of someone you love. We have compiled lists of questions that we believe will help you discover important information and establish a good relationship (Select Education and Support/Publications and Products/Questions for Doctors).
Q. What is the purpose of a second opinion? Is it important?
A. The purpose of a second opinion is to validate the first opinion or explore another option. The desire for a second opinion is legitimate and valid. We do this all the time in many aspects of our lives: we get multiple bids from contractors and auto repair shops; we switch insurance companies and banks without agonizing over the decision or feeling either stupid or traitorous to the original provider. The process of making decisions about medical care is a lot more complicated. It is important to understand that you, as the patient or patient’s family, are the ultimate decision maker about who provides health care. It is imperative that you feel comfortable and respected in this relationship and that you feel free to seek a second opinion when it is appropriate.
Q. I am pregnant and my unborn child was just diagnosed with Hydrocephalus, what should I do next?
A. We recommend you consult with a pediatric neurosurgeon in your area. You may also want to read our short booklet about prenatal diagnosis of hydrocephalus.
Share