Hydrocephalus

Hydrocephalus is a condition that occurs when cerebrospinal fluid (CSF) builds up in the brain, typically due to an imbalance between the production and absorption of cerebral spinal fluid. This often results in increased intracranial pressure, which can cause long-term issues if left untreated. Hydrocephalus can occur on its own or be associated with other conditions.

Infants

• Head enlargement
• Tense or bulging soft spot
• Prominent scalp veins
• Persistent vomiting
• Less interest in feeding
• Irritability and/or sleepiness
• Downward deviation of the eyes

Children, Adolescents and Adults

• Persistent vomiting
• Persistent headache
• Irritability and/or sleepiness
• Downward deviation of the eyes

If your child is displaying any signs or symptoms of hydrocephalus, imaging may be necessary to evaluate the fluid in their brain. Hydrocephalus can be diagnosed using three major techniques:

• Ultrasound (US)
• Computerized tomography (CT)
• Magnetic Resonance Imaging (MRI)

Here at Connecticut Children’s, our pediatric neurosurgeons have expertise in using several techniques to treat hydrocephalus:
A shunt, the most common method for treating hydrocephalus, is surgically implanted to drain excess cerebrospinal fluid from the ventricles of the brain to another area of the body—the abdomen, typically—where it will be absorbed by your child’s body.

A shunt has 3 parts:

• A short catheter (a thin, flexible tube) draining fluid from the brain into the valve
• A one-way valve with a reservoir sitting under the scalp
• A long catheter draining fluid from the valve into a body cavity

There are a variety of different shunt valves. The two main types are programmable valves and non-programmable valves:

Programmable shunt valve

• Shunt setting can be externally adjusted with the use of a special magnetic device
• Keep away from toys with magnets and other sources of magnetic fields
• Shunt will need to be reprogrammed following MRIs. No precautions needed for CT scans or X-rays

Non-programmable shunt valve

• Unable to adjust the setting after placed. Your child’s surgeon will determine the proper setting prior to implanting
• No precautions needed with magnetic objects
• No precautions needed for MRIs, CT scans or X-rays

Endoscopic third ventriculostomy (ETV) surgery eliminates the need for a shunt in some children, especially those who have a blockage in their cerebrospinal fluid pathways. During an ETV, our neurosurgeons use a small camera to make a hole in the bottom of the brain’s third ventricle in order to provide an internal bypass for the fluid.

Our pediatric neurosurgeons will review your child’s diagnosis with you and work with you to select the best treatment option. We take pride in maintaining a close relationship with our patients and their families, and provide long-term follow-up for all of our patients with hydrocephalus. As our patients enter adulthood, we work closely with them in order to provide a smooth and effective transition to an adult provider.