Menu   WellSpan Health

Health Library

Health Library


What is hydrocephalus?

Hydrocephalus is a condition in which there is excessive cerebro spinal fluid (CSF) fluid in and around the brain. It occurs when this fluid is not absorbed, becomes blocked, or is overproduced. The ventricles are fluid-filled areas of the brain. The CSF disperses from the ventricles around the brain and spinal cord. Too much CSF may result in a buildup of fluid that can cause the pressure inside of the head to increase. In a child, this causes the bones of the skull to expand and separate to a larger-than-normal appearance.

What causes hydrocephalus?

Illustration of hydrocephalus

Hydrocephalus occurs in about 1 out of 500 births. The following are the primary reasons why hydrocephalus occurs:

  • Blockage of the CSF flow inside of the head

  • Problems absorbing CSF

  • Overproduction of CSF (rare)

Hydrocephalus can occur either as a condition present at birth (congenital), or it can be acquired later in life. In some babies the condition is genetic, such as in babies with congenital aqueductal stenosis. Other conditions, such as neural tube defects (like spina bifida), are also associated with hydrocephalus. Other causes include premature birth, infections, tumors, or bleeding inside the brain. 

Causes of acquired hydrocephalus may include:

  • Tumor

  • Infection

  • Prematurity

  • Bleeding inside the head

  • Birth injury

  • Abnormal blood vessel formation inside of the head

  • Injury

What are the symptoms of hydrocephalus?

The following are the most common symptoms of hydrocephalus in babies:

  • A full or bulging fontanel (soft spot located on the top of the head)

  • Increasing head circumference (size)

  • Seizures

  • Bulging eyes and an inability of the baby to look upward with the head facing forward

  • Prominent scalp veins

  • Increased irritability

  • High-pitched cry

  • Poor feeding

  • Projectile vomiting

  • Sleepiness or less alert than usual

  • Developmental delays

The symptoms of hydrocephalus may look like other conditions or medical problems. Always consult your baby's doctor for a diagnosis.

How is hydrocephalus diagnosed?

Hydrocephalus may be diagnosed before birth by prenatal ultrasound, a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels. In many cases, hydrocephalus doesn't develop until the third trimester of the pregnancy and, therefore, may not be seen on ultrasounds performed earlier in pregnancy.

The diagnosis of congenital hydrocephalus may be made at birth and after diagnostic testing. During the examination, the doctor takes a complete prenatal and birth history of the baby. He or she may also ask if there's a family history of hydrocephalus or other medical problems. The doctor will also ask about developmental milestones in older babies since hydrocephalus can be associated with developmental delay. Developmental delays may require further medical follow-up for underlying problems.

The baby's head may appear larger than normal. A measurement of the circumference of the baby's head is taken and compared to a graph that can identify normal and abnormal ranges for a baby's age.

Diagnostic tests that may be done to confirm hydrocephalus include:

  • Ultrasound. This diagnostic test uses sound waves to create an image of an internal portion of the body and can be used to determine the size of the ventricles in the womb and in neonates.

  • Magnetic resonance imaging (MRI). This diagnostic procedure uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.

  • Computed tomography (CT) scan. This diagnostic imaging procedure uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

What is the treatment for hydrocephalus?

The goal of treatment is to reduce the pressure in the baby's head and to properly drain the cerebral spinal fluid (CSF). Occasionally, medications or procedures to draw off the extra CSF may be used.

Surgery may be needed for some cases of hydrocephalus. Surgery usually involves placing a mechanical shunting device into the baby's head to help drain the extra CSF from the brain and redirect the extra fluid to another part of the body to be absorbed. A common type of shunt is the ventriculoperitoneal shunt. This directs the fluid into the abdominal cavity.

Illustration demonstrating ventriculoperitoneal shunt placement

The shunt consists of 3 parts:

  1. A tube that's placed inside the ventricular space

  2. A reservoir and valve to control the flow of CSF

  3. Tubing that's directed under the skin to the abdomen, or less commonly to the heart or lung area

The shunt redirects the CSF out of the head through the tubing to a location elsewhere in the body where it can absorbed. The shunt usually runs behind the ear and the tubing is tunneled under the skin to the area of the abdomen, heart, or lung. Your baby's doctor will determine the drainage location based on your baby's condition, age, and other factors. The abdomen is generally the first choice.

Potential complications from the shunts or surgery can include:

  • Infection

  • Shunt malfunction that results in underdrainage or overdrainage of the CSF

  • Bleeding

These symptoms require prompt medical evaluation. Following surgery, you'll receive instructions on how to care for your baby at home and information about signs or symptoms requiring immediate medical attention.

Life-long considerations

Hydrocephalus can affect the brain and a baby's development. The extent of the problem is dependent on the severity of the hydrocephalus, and the presence of brain or other organ system problems.

The key to treating hydrocephalus is early detection, proper treatment, and prevention of infection. A baby with hydrocephalus requires frequent medical evaluations to ensure proper shunt function. The medical team works closely with the family to provide education and guidance as the baby grows and develops.

Genetic counseling may be recommended by the baby's doctor to discuss the risk for recurrence in future pregnancies, as well as prenatal testing for hydrocephalus.

Hydrocephalus - WellSpan Health

Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Online Medical Reviewer: Trevino, Healther, M., BSN, RNC
Last Review Date: 2014-09-28T00:00:00
Last Modified Date: 2014-09-30T00:00:00
Posting Date: 2008-11-30T00:00:00
Published Date: 2014-09-30T00:00:00
Last Review Date: 2007-03-30T00:00:00
© 2016 WellSpan Health. All Rights Reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

I would like to:

Are you sure you would like to cancel?

All information will be lost.

Yes No ×

About the provider search

This search will provide you with WellSpan Medical Group and Northern Lancaster County (Ephrata) Medical Group primary care physicians and specialists. If we don’t have a WellSpan Medical Group physician to meet your criteria, the search will expand to include community physicians who partner with WellSpan Medical Group physicians through the WellSpan Provider Network or provide care to patients on the Medical Staffs of WellSpan’s Hospitals.


Schedule Your Next Appointment Online with MyWellSpan

Use your MyWellSpan patient portal any time to view available appointments, and pick the date and time that best suits your schedule.

Go to MyWellSpan

New to this practice?

If you don't have a WellSpan primary care provider and would like to schedule a new patient appointment with a provider who is accepting patients, just log into your MyWellSpan account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to see the offices that are accepting new patients in relation to your zip code. If you are not enrolled in MyWellSpan, go to, call 1-866-638-1842 or speak with a member of the staff at a participating facility to sign up. New patient scheduling not available at all practices/programs.

Already a patient at this practice?

If you already have a relationship with a WellSpan practice, simply log into your account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to schedule an appointment with any provider or practice that already counts you as a patient. Online scheduling varies by practice/program.