Causes of hydrocephalus

Written by Gao Yi Shen
Neurosurgery
Updated on February 19, 2025
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There are many causes of hydrocephalus, and it is important to make specific judgments based on the circumstances. In some infants, congenital hydrocephalus can be caused by intracranial birth injuries, which occur during the birth process and lead to intracranial hemorrhaging. It can also be due to congenital developmental abnormalities, such as anencephaly or spina bifida. In adults, hydrocephalus can be caused by intracranial tumors, such as choroid plexus papillomas, which overproduce cerebrospinal fluid. Others might develop hydrocephalus due to blockages caused by blood clots, such as cerebral hemorrhage or subarachnoid hemorrhage. There are also cases where hydrocephalus can occur alongside chronic conditions like subdural hematoma or epidural hematoma, depending on the specific clinical presentations of the patients.

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Written by Chen Yu Fei
Neurosurgery
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Can hydrocephalus be drained?

For patients with hydrocephalus, surgery is generally recommended. A common surgical option is the ventriculo-peritoneal shunt procedure, where a drain tube is placed in the patient's ventricular system. Through this surgery, excess cerebrospinal fluid is drained from the ventricular system to the patient's abdominal cavity, achieving a new balance. Most patients who undergo surgery achieve desirable outcomes, with initial symptoms and physical signs likely improving gradually. Over time, the patient's ventricular system may reduce in size, and may even return to normal. Therefore, for most patients with hydrocephalus, the surgical outcome is quite certain, and it is advised to opt for surgery at an early stage.

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Neurosurgery
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Hydrocephalus should be treated in the neurology department.

If you have hydrocephalus, it is recommended to visit the neurosurgery department at your local hospital and ask a neurosurgeon to assess your current condition. It is generally advised that patients undergo a cranial CT scan or MRI to determine the extent and severity of the hydrocephalus and to choose the appropriate treatment method. For static hydrocephalus, most patients do not exhibit clear clinical symptoms and generally do not require special treatment, regular monitoring is sufficient. For progressive hydrocephalus, surgical treatment is often necessary, and it is generally recommended that patients undergo ventriculoperitoneal shunt surgery. With surgical treatment, most patients can achieve satisfactory results.

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How to prevent hydrocephalus?

To prevent hydrocephalus, it is first recommended to cultivate good living habits, such as a diet low in salt and fat, and light in nature. Avoid eating overly greasy, spicy, and irritating foods. Additionally, engage in aerobic exercise daily, keeping it under 30 minutes, which can effectively prevent the occurrence of hydrocephalus. For patients with severe cranial trauma or serious central nervous system infections, toxic encephalopathy, etc., if the patient's condition is stable, a timely follow-up head CT scan should be conducted to dynamically observe changes in the patient’s condition. Furthermore, if some patients do not have clear contraindications for surgery, considering a lumbar puncture might be an option to maintain the fluid flow in the brain and prevent hydrocephalus.

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Neurology
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How to relieve headache caused by hydrocephalus?

Hydrocephalus causing headaches is generally related to high pressure in the brain. Hydrocephalus leads to an enlargement of the ventricular system, compressing the surrounding brain tissue. Since the volume of the skull is fixed, increased accumulation of fluid can cause a rapid rise in internal pressure, leading to headaches. In severe cases, it may cause nausea, vomiting, and disturbances in consciousness, making the patient drowsy, stuporous, or even comatose. In such cases, the main treatment is to reduce the pressure inside the brain. Dehydrating agents, such as mannitol, can be used; however, mannitol mainly removes water from inside the cells and is more effective for cerebral edema than for hydrocephalus. Furosemide can be used to reduce the secretion of cerebrospinal fluid and may have some effect on hydrocephalus. However, the key treatment is likely to be surgical, such as lateral ventricular drainage, which can fundamentally resolve the problem of fluid accumulation but can also lead to complications like infections.

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Is hydrocephalus easy to treat?

For patients with hydrocephalus, it is generally recommended to treat the condition surgically. Before the surgery, the patient should undergo a cranial CT or MRI to assess the type and severity of the hydrocephalus. If possible, a lumbar puncture should also be performed before the surgery to determine whether there is a significant increase in intracranial pressure, and a small amount of cerebrospinal fluid should be collected for routine and biochemical analysis of the cerebrospinal fluid. If there are no obvious contraindications to surgery, clinically, it is generally recommended to choose a ventriculoperitoneal shunt surgery. Most patients respond well to the surgery, and the morphology of the ventricular system gradually returns to normal.