What is congenital hydrocephalus?

Hydrocephalus in newborns: Overview

Hydrocephalus means that too much fluid is building up inside your baby's brain. This extra fluid can increase pressure on the brain. It can make your baby's head look larger than normal and make the soft spots on your baby's head feel firm or bulge out.

Early treatment for your newborn can help protect the brain from long-term injury.

The goal of treatment is to lower the pressure on the brain by getting rid of the extra fluid. There are two common ways to do that:

  • The doctor may place a flexible tube, called a shunt, in your baby's brain. The shunt carries the extra fluid away from the brain to another part of your baby's body, such as the belly or heart. Your baby's body can take in the extra fluid without harm.
  • The doctor may perform a surgery called ETV (endoscopic third ventriculostomy). In ETV, the doctor makes a small hole in a deep part of your baby's brain. The hole allows the extra fluid to flow out of the brain and into the body, where it can be taken in without harm.

What happens when your child has congenital hydrocephalus?

No matter what kind of treatment your child has had, you and your child's doctors will need to watch your child closely to make sure that the fluid in the brain continues to drain. Pressure can build up in the brain again. Shunts can become blocked or infected. These problems need to be treated right away.

Symptoms such as irritability, poor appetite, sleeping too much, and vomiting may be signs that fluid has built up again. After early childhood, there may be other symptoms to watch for, such as headaches, vision problems, or problems walking. Shunt infections may also cause a fever and redness along the shunt tract or valve.

As your child grows, you'll need to watch for problems with brain development. These could include things like delayed learning, problems with motor skills, and speech problems. Talk to your doctor about any new problems or changes you see.

What are the symptoms of congenital hydrocephalus?

The clearest symptom of hydrocephalus is a head that is larger than normal. You and your doctor may notice it when the baby is born. Your baby's head may grow faster than the normal rate for a baby's height and weight. They may also be irritable, sleep too much, vomit, or eat very little.

How is congenital hydrocephalus treated?

Early treatment can help limit or prevent injury to the brain. Treatment focuses on reducing the amount of fluid in the brain to relieve pressure.

The doctor may place a flexible tube, called a shunt, in the brain to drain the fluid. The shunt carries fluid to another part of the body (usually the belly or the heart), which then absorbs the fluid. The shunt may stay in the brain for life, though it may have to be fixed or replaced later if it becomes blocked or infected.

A surgery called endoscopic third ventriculostomy (ETV) may be used. In ETV, a small hole is made in the deep part of the brain so that the fluid in the brain can flow freely.

Sometimes emergency treatment is needed to reduce the fluid. This may include medicines, a lumbar puncture (sometimes called a spinal tap), or a procedure to drain fluid from the brain until a shunt can be put in.

If your child has any developmental problems or delays caused by an injury to the brain, your doctor can help you find the care you need. Treatment will focus on the specific problems your child has. For example, speech therapy can help with speech delays. Physical therapy can help with motor skill problems.

How is congenital hydrocephalus diagnosed?

A fetal ultrasound can sometimes show the problem before birth. But most cases are found during an exam soon after birth. Your doctor may suspect that your baby has congenital hydrocephalus if your baby's head is larger than normal. Imaging tests, such as a CT scan, an MRI, or an ultrasound, may be needed.

What causes congenital hydrocephalus?

This condition is caused by an imbalance between how much fluid the brain makes and how well the body is able to process it.

Normally, fluid flows through and out of chambers of the brain called ventricles, and then around the brain and spinal cord. The fluid is then absorbed by the thin tissue around the brain and spinal cord. But with hydrocephalus, the fluid can't move where it needs to or is not absorbed as it should be. And in rare cases the brain makes too much fluid.

Congenital hydrocephalus may happen because of:

  • Bleeding in the fetus before birth.
  • Certain infections in the birth parent, such as toxoplasmosis or syphilis.
  • Conditions present at birth, like spina bifida.
  • A genetic condition.

Congenital hydrocephalus

Inside views of normal brain of baby and brain with hydrocephalus that shows enlarged head and ventricles filled with extra fluid.

Congenital hydrocephalus is a condition present at birth in which too much cerebrospinal fluid (CSF) collects inside the brain. Fluid may not drain from the brain's passageways (ventricles) or may not be absorbed as it should be. This leads to increased pressure within the brain.

Usually a baby with this condition will have a bigger head than other babies the same age. Early treatment can help limit or prevent long-term problems.

How can you care for your newborn who has hydrocephalus?

Watch for possible problems as your baby's brain develops. These could include delayed learning, problems with motor skills, and speech problems. Talk to your doctor about new problems or changes you see. Take care of yourself. Get enough rest, eat well, and exercise. Ask your doctor where to find help and support.

Hydrocephalus in newborns: When to call

Call 911 anytime you think your baby may need emergency care. For example, call if:

  • Your baby passes out (loses consciousness).
  • Your baby has a seizure that does not go away.

Call your doctor now or seek immediate medical care if:

  • Your baby has signs that fluid is building up in the brain. Signs include:
    • Extreme fussiness or crying that can't be comforted.
    • Being much less alert than usual.
    • Not eating much.
    • Sleeping a lot.
    • Vomiting.
    • Fever.

Watch closely for changes in your baby's health, and be sure to contact your doctor if you have any concerns.

©2011-2024 Healthwise, Incorporated

The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.