Hydrocephalus: Understanding “Water on the Brain”

What is Hydrocephalus? Understanding “Water on the Brain”

Hydrocephalus, often called “water on the brain,” is a medical condition where there is an abnormal accumulation of cerebrospinal fluid (CSF) in the brain’s ventricles. This buildup can cause the ventricles to swell, putting harmful pressure on the surrounding brain tissue. While hydrocephalus can be congenital (present at birth), it can also develop later in life due to head injuries, tumors, or infections. Early diagnosis and treatment are crucial to prevent or minimize brain damage.

Types of Hydrocephalus and Their Causes

Hydrocephalus is categorized into two main types based on the flow of cerebrospinal fluid. Communicating hydrocephalus occurs when the flow of CSF is blocked after it leaves the ventricles. This is often caused by a subarachnoid hemorrhage, meningitis, or a tumor. In contrast, non-communicating hydrocephalus (or obstructive hydrocephalus) happens when the flow of CSF is blocked along one or more of the narrow passages connecting the ventricles. Common causes include a tumor, malformation, or a cyst. Each type requires a specific diagnostic approach and treatment strategy.

Diagnosis and Treatment: The Role of a Neurologist

Diagnosing hydrocephalus begins with a physical exam and a review of symptoms, which can include headaches, nausea, vision problems, and cognitive decline. The primary diagnostic tool is brain imaging, with a CT scan or MRI providing detailed images of the ventricles. An MRI is particularly useful as it can show the exact location of a blockage and provide a clear picture of the fluid buildup. Once diagnosed, the most common treatment is the surgical insertion of a shunt. A shunt is a medical device—a flexible tube—that is placed in the brain to divert the excess CSF to another part of the body, where it can be absorbed. In some cases, a procedure called endoscopic third ventriculostomy (ETV) can be performed to create a bypass for the CSF.