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Hydrocephalus In Children

What is hydrocephalus?

Hydrocephalus is a condition that is caused by too much cerebrospinal fluid (CSF) inside the ventricles of your child's brain. Ventricles are spaces inside the brain where cerebrospinal fluid (CSF) is produced. CSF surrounds the brain and spinal cord. CSF is constantly being made and absorbed by your child's body. It moves through ventricles before it drains out and gets absorbed into his bloodstream. When CSF cannot drain properly, the fluid pressure may cause the ventricles to swell.

Hydrocephalus

What increases my child's risk for hydrocephalus?

Your child may have been born with hydrocephalus. The following can also increase his risk:

  • Infections in the mother during pregnancy caused by bacteria or a virus

  • Problems during the growth of the fetus that may cause defects in the brain

  • Head injuries or trauma

  • Infections in the brain and its coverings

  • Prematurity (being born too early), which may increase his risk for bleeding in the brain

  • Tumors that may decrease or block the flow of CSF

What are the signs and symptoms of hydrocephalus?

The signs and symptoms of hydrocephalus may vary depending on the age of your child.

  • Infants and young children: The most common sign is a rapid increase in head size. The head size increases because the bones of a baby's skull have not yet fused together. Other signs and symptoms include the following:

    • Eyes that are turned downward

    • Bulging fontanelles (soft spots of the head)

    • Fussiness, restlessness, or crying more than normal

    • Problems with holding the head up, or frequent bobbing of the head

    • Seizures

    • Sleepiness

    • Vomiting

  • Older children: The bones of the skull in older children may have fused, which may cause different symptoms than those seen in infants:

    • Blurring of vision or double vision

    • Drowsiness

    • Headaches that have occurred over a long period of time

    • Nausea or vomiting

    • Mood changes, learning problems, and memory loss

    • Problems in controlling urination

    • Problems with balance and walking

How is hydrocephalus diagnosed?

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your child's brain. The pictures may show bleeding or excess fluid. Your child may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if your child has ever had an allergic reaction to contrast dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your child's brain. An MRI may show the cause of a blockage, such as narrowing of a passage between ventricles. Your child may be given dye to help the pictures show up better. Tell the caregiver if your child has ever had an allergic reaction to contrast dye. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if your child has any metal in or on his body.

  • Lumbar puncture: This procedure may also be called a spinal tap. A small needle is placed into your child's lower back. Fluid will be removed from around your child's spinal cord and sent to the lab for tests. The test is done to check for bleeding around your child's brain and spinal cord, and for infection. This procedure may also be done to take pressure off your child's brain and spinal cord, or to give medicine. Your child may need to be held in place so that he does not move during the procedure.

  • Ultrasound: An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to show changes in his brain or ventricles that may indicate hydrocephalus.

How is hydrocephalus treated?

Treatment should begin as soon as possible to prevent brain injury.

  • Surgery:

    • Shunt: Caregivers put a flexible tube into your child's ventricle. The tube helps drain CSF out of the brain and into his abdomen or chest.

    • Ventriculostomy: This is also called endoscopic third ventriculostomy, or ETV. Caregivers use a tool called an endoscope to look into your child's brain and ventricles. An endoscope is a thin, flexible tube with a camera at the end. Caregivers make a hole through the third ventricle to allow the CSF to drain and be absorbed by your child's body.

  • Lumbar puncture: This procedure may also be called a spinal tap. A small needle is placed into your child's lower back. Fluid will be removed from around your child's spinal cord and sent to the lab for tests. The test is done to check for bleeding around your child's brain and spinal cord, and for infection. This procedure may also be done to take pressure off your child's brain and spinal cord, or to give medicine. Your child may need to be held in place so that he does not move during the procedure.

  • Diuretics: Your child may be given diuretics to help decrease the swelling in his brain.

What are the risks of hydrocephalus?

Without treatment, the increased pressure inside the skull may damage the brain and cause lifelong problems. These include retardation, cerebral palsy, seizures, and possibly death. If your child is has shunt surgery, he may get an infection, or the shunt can become blocked or stop working.

Where can I find support and more information?

  • Hydrocephalus Association
    870 Market Street, Suite 955
    San Francisco , CA 94102
    Phone: 1- 415 - 732-7040
    Phone: 1- 888 - 598-3789
    Web Address: http://www.hydroassoc.org
  • The Hydrocephalus Foundation, Inc.
    910 Rear Broadway
    Saugus , MS 01906
    Phone: 1- 781 - 942-1161
    Web Address: http://www.hydrocephalus.org

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • Your child has a fever.

  • Your child becomes more fussy, restless, or sleepy than usual.

  • Your child seems confused or does not know his family or friends.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your child's headache is getting worse, even after you give him pain medicine.

  • Your child has trouble hearing, talking, or seeing.

  • Your child has a bulging fontanel (soft spot on the top of his head).

  • Your child has problems walking or weakness in an arm or leg.

  • Your child has a seizure.

  • Your child is vomiting and cannot keep any liquids down.

  • Your child has a shunt and he has pain in his abdomen.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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