Cerebral Palsy and Hydrocephalus: Essential Facts to Know

Cerebral Palsy and Hydrocephalus: Understanding the Connection

Cerebral palsy (CP) is the most common cause of lifelong movement disability in the world. The term CP refers to a group of movement disorders impacting how a person generates, coordinates, and controls movement and posture. When someone has CP, there can be many possible causes. These different causes (i.e., infant stroke, infection, prematurity, or genetic changes, etc.) impact the development of areas of the brain responsible for movement in early life, before, during, or shortly after birth. The initial cause of CP is not progressive, but the way CP impacts the body over time may change and cause changes in function. 

For people with hydrocephalus, the risk of developing CP is often related to the same underlying cause of hydrocephalus, such as brain injury in infancy, prematurity, intraventricular hemorrhage, or congenital malformations. Hydrocephalus can sometimes exacerbate motor difficulties in children with CP due to increased intracranial pressure or complications related to shunt surgery.

How Common Is Cerebral Palsy in People with Hydrocephalus?

Studies indicate that cerebral palsy is relatively common among individuals with congenital hydrocephalus.  

• Around 83% of premature infants with posthemorrhagic hydrocephalus also have or develop cerebral palsy. 
• An estimated 20-30% of infants diagnosed with hydrocephalus also have cerebral palsy. 
• Nearly 8% of children with spina bifida and hydrocephalus have cerebral palsy.  

The likelihood of CP in individuals with hydrocephalus often depends on the severity and timing of the brain injury that caused the hydrocephalus.

Signs and Symptoms of Cerebral Palsy

Cerebral palsy can affect each person differently, depending on the area of the brain involved and the severity of the injury. While CP is primarily known for its impact on the musculoskeletal system (how the muscles and bones work together), it can also impact other areas of development and function.  

Because cerebral palsy affects the brain, symptoms can extend beyond movement. However, the list below focuses on motor-related signs, which are often the earliest and most recognizable. 

• Muscle stiffness or tightness (spasticity), making movement more difficult 
• Muscle weakness or low tone, leading to floppy or less controlled movements 
• Difficulty with coordination and balance, affecting walking, sitting, or other daily activities 
• Involuntary movements or tremors 
• Delayed motor milestones, such as rolling, crawling, or walking later than typical 
• Challenges with posture and body positioning, which may affect sitting, standing, or holding objects 

In addition to motor symptoms, some individuals with CP may also have other conditions with: 

• Speech and communication  
• Vision or hearing  
• Learning or cognitive development  
• Feeding or swallowing  

Some individuals may have only mild symptoms, while others may need therapies or support with daily activities.

Managing Cerebral Palsy in People With Hydrocephalus

For individuals who have both CP and hydrocephalus, care often involves a multidisciplinary team that may include: 

• Neurologists and neurosurgeons 
• Physical, occupational, and speech therapists 
• Rehabilitation specialists 
• Assistive technology experts 

Treatment focuses on: 

• Supporting mobility, coordination, while also addressing other areas of development that may be impacted by the initial brain injury that caused CP (such as vision, cognition, or neurological conditions like epilepsy) 
• Managing hydrocephalus and preventing complications from shunts 
• Providing therapies to improve daily functioning and quality of life 

Care should take a proactive, whole-person approach, recognizing that CP can affect multiple areas of the brain, not just movement. Identifying and addressing related conditions early, such as cerebral visual impairment (CVI) or epilepsy, can help prevent delays in care and improve outcomes. 

Early diagnosis, consistent monitoring, and coordinated care can make a meaningful difference in long-term outcomes.

Living With Cerebral Palsy and Hydrocephalus

Children and adults living with both CP and hydrocephalus can benefit from early interventions, therapy, and supportive communities. While CP is lifelong, advances in medical care, rehabilitation, and assistive technology can help support people with CP to pursue activities they enjoy and find meaningful. Understanding the connection between CP and hydrocephalus allows families and caregivers to advocate for proper care, recognize symptoms, and access resources for ongoing support. 

For additional support and educational resources, we encourage you to contact the Cerebral Palsy Research Network. 

Information you can trust! This article was produced by the Hydrocephalus Association, copyright 2026. We would like to thank Michele Shusterman for her valuable contribution and expert input.