Hydrocephalus occurs when cerebrospinal fluid (CSF) accumulates in the ventricles of the brain, causing them to enlarge and increase pressure on the surrounding brain tissue. CSF normally circulates through the ventricles and around the brain and spinal cord before being absorbed. When this circulation is blocked or absorption is impaired, fluid builds up.
Hydrocephalus can occur at any age. In adults, it may develop after head injury, brain hemorrhage, infection, or tumor, or it may appear gradually without an identifiable cause (normal pressure hydrocephalus). Without treatment, the increased pressure can cause permanent brain damage.
How Hydrocephalus Presents
Symptoms vary depending on age and how quickly the condition develops. In adults, the presentation depends on whether the hydrocephalus is acute (rapid onset) or chronic (gradual).
- Headaches, often worse in the morning or when lying flat
- Nausea and vomiting
- Vision changes, including blurred or double vision
- Balance and gait difficulties (especially in normal pressure hydrocephalus)
- Cognitive decline, including memory problems and slowed thinking
- Urinary urgency or incontinence
- Drowsiness or lethargy in acute cases
Evaluation and Next Steps
Hydrocephalus is diagnosed with CT or MRI imaging, which shows enlarged ventricles. Additional testing may include lumbar puncture to measure CSF pressure and assess symptom response to fluid removal. Dr. Waldron evaluates the underlying cause and recommends the most appropriate treatment, which typically involves CSF diversion through a programmable shunt system or, in select cases, endoscopic third ventriculostomy.