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Hydrocephalus is the build-up of excess fluid in your brain. You may have also heard hydrocephalus referred to as 'water on the brain'.
The fluid is not in fact water, but something called cerebrospinal fluid (CSF). CSF has important functions, including protecting your brain from damage, removing waste from your brain, and providing nutrients to your brain, which help it to function and stay healthy. Typically, when your brain produces new cerebrospinal fluid, it simultaneously releases the old fluid from your brain and into your blood vessels.
Hydrocephalus most commonly happens when this process of releasing fluid from your brain is broken. This means that excess CSF builds up in your skull, which causes raised pressure inside it. If left untreated, hydrocephalus can cause damage to your brain. This may include brain damage that causes intellectual impairments, problems with physical development, and can sometimes even be fatal.
If you have hydrocephalus or have symptoms that might point to it, our team of experienced brain surgeons could help you to find the right treatment.
Hydrocephalus can develop in both adults and children and we don't always know why it happens.
Sometimes the cause of hydrocephalus is related to an absorption problem. In other instances there is a blockage in the channels through which the CSF flows (known as obstructive hydrocephalus). Occasionally the problem is due to excessive production of cerebrospinal fluid. The result of all of these is that excess CSF puts pressure on the brain.
If hydrocephalus is present at birth, it is sometimes known as congenital hydrocephalus. If it develops any time after birth, it might be referred to as acquired hydrocephalus.
When hydrocephalus develops in adults and children, it is often thought to be caused by an illness or injury, such as head injury, haemorrhage, or a tumour. Some tumours, for example, create a blockage on the brain which means the CSF fluid cannot drain out. An infection such as meningitis may also cause hydrocephalus.
The symptoms of excess fluid in the brain vary, depending on the age of person that is affected. Some symptoms of acquired hydrocephalus include:
- Headaches
- Neck pain
- Nausea
- Drowsiness or sleepiness
- Blurred vision
- Personality or behavioural changes
- Walking difficulties
- Inability to control your bladder (bladder incontinence) and/or your bowels (bowel incontinence)
The first step towards getting your diagnosis at Circle Health Group is an initial consultation with a brain specialist. They will take your medical history, asking you lots of detailed questions, and ask you to talk through your symptoms, again in lots of detail. They will want to know what symptoms your experiencing, when your symptoms started to how they affect your daily life.
From this, if your consultant suspects that you may have excess fluid on the brain, they will then complete a physical examination. This may include assessments of:
- Your gait (how you walk)
- Your mental ability
Your consultant will also request a CT scan and an MRI scan to allow them to look at the brain in detail, which may indicate excess fluid on the brain or increased pressure.
In order to get the most accurate diagnosis and make sure they identify the best treatment for your individual circumstances, your consultant may also request additional tests which could include:
- Lumbar puncture
- Lumbar drainage test
- Lumbar infusion test
Once a diagnosis has been confirmed, your consultant will talk you through the available treatment options, and together you’ll decide on the best course of action.
Normal pressure hydrocephalus (NPH) is a type of hydrocephalus that typically affects older people. The symptoms tend to develop slowly, over a number of months or years. The symptoms of NPH are similar to those caused by dementia, which at times can lead to misdiagnosis.
There are three characteristic symptoms of NPH: it affects your mobility, your urinary system, and your mental abilities.
Mobility issues
If you suffer from NPH, you may notice a change in your gait (how you walk) as one of the early symptoms. This may include struggling to take the first step or feeling 'frozen' to the spot. You may also find it difficult to take proper steps and resort to shuffling.
Urinary problems
You may experience recurring episodes of urinary incontinence which could include the following symptoms:
- A frequent need to pee
- An urgent need to pee
- Loss of bladder control
Disrupted mental abilities
Your normal mental faculties or thinking process may slow down. You may experience the following:
- You are slow to respond to questions
- React slowly to situations
- Are slow to process information
Normal pressure hydrocephalus (NPH) can sometimes be treated with shunt surgery. Due to the risks of surgery and the likely increased vulnerability of older patients, tests will be carried out beforehand to ensure that shunt surgery is the most appropriate course of action for each individual patient.
If a patient is diagnosed with hydrocephalus, the condition can be treated one of two ways: with either shunt surgery or a neuroendoscopy.
Shunt surgery
During shunt surgery, a thin tube known as a 'shunt' is implanted in your brain. The shunt acts as a pipe with valves through which the excess CSF can drain away from your brain and into another part of your body, typically your stomach, where it is absorbed into your blood.
After surgery, you will be able to feel the shunt as a small lump under the skin on your scalp.
Endoscopic third ventriculostomy (neuroendoscopy)
An alternative treatment for hydrocephalus is endoscopic third ventriculostomy (ETV), which is a type of neuroendoscopy. While a shunt drains CSF through the addition of a tube, ETV works by creating a small hole at the bottom of the brain, through which the excess fluid can drain.
Your neurosurgeon uses an endoscope to look into the chambers of your brain and to make the hole. This procedure is only applicable to certain type of hydrocephalus.
When you go private with Circle, you can expect:
- Fast access to appointments with brain specialists, often within 48 hours of getting in touch
- Your choice of consultant, at a hospital location that suits you
- Flexible appointment times to fit your schedule
- Consultant-led treatment from start to finish
- Bespoke treatment plans built around your individual needs
- Private ensuite rooms as standard with TV and wifi included
- Flexible payment options to help you spread the cost
If you have been diagnosed with hydrocephalus or have symptoms that point to the condition, call us or book online today and we'll help you find the best treatment for you, fast.
Content reviewed by Circle in-house team in September 2022. Next review due September 2025.
