Symptoms of hydrocephalus vary with age, disease progression, and individual differences in tolerance to CSF.  Older children and adults may experience different symptoms because their skulls cannot expand to accommodate the buildup of CSF. In older children or adults, symptoms may include headache followed by vomiting, nausea, papilledema (swelling of the optic disk which is part of the optic nerve), blurred vision, (double vision), problems with balance, poor coordination, gait disturbance, urinary incontinence, slowing or loss of development, lethargy, drowsiness, irritability, or other changes in personality or cognition including memory loss.

Some other terms or diagnoses for Hydrocephalus include:

• Hydrocephaly
• "Water on the Brain"
• Hydranencephaly (this extremely rare form of Hydrocephalus involves the absence of portions of the brain)
• Hydrocephalus is believed to occur in about 2 out of 1,000 births. The incidences of adult-onset hydrocephalus and acquired hydrocephalus are not known.

Treatment

While hydrocephalus is very treatable, the underlying cause may not be or may have caused irreversible damage to the brain. It is important for the doctors taking care of a child with hydrocephalus to determine if the problem is ongoing or if it has resolved but left enlarged but stable ventricles. This can sometimes be difficult to tell and often the decision will be based on many factors including symptoms, eye exams, changes in level of activity or school performance. In addition to this often the child will have repeated (serial) radiographic exams to look for changes in the ventricles.

The most effective treatment is surgical insertion of a shunt - a flexible tube placed into the ventricular system that diverts the flow of CSF into another region of the body where it can be absorbed, such as the peritoneal (abdominal) cavity or the right atrium of the heart.

Endoscopic third ventriculostomy (ETV) is growing in popularity as an alternative treatment method for hydrocephalus - the surgery involves making a hole in the floor of the third ventricle to allow free flow of spinal fluid into the basal cisterns for absorption.

Prognosis

Prior to the advent of computerized axial tomography (CAT scans), the prognosis for children with hydrocephalus was generally poor. It was believed that an abbreviated life span would be plagued by numerous shunt revisions and associated complications. There was little optimism concerning physical and intellectual well-being over the course of a lifetime; both parents and physicians were exasperated by the many problems associated with the equipment available to manage the condition.  The CAT scan has changed this situation enormously. Most parents can now look forward to the likelihood of normal longevity with little or no intellectual or physical impairment.  While the prognosis for successful management of hydrocephalus is excellent, it is however the underlying cause that will ultimately determine a child's
outcome.

Other Information Resources

• The Hydrocephalus Association
  http://www.hydroassoc.org
• Hydrocephalus Center
  http://www.patientcenters.com/hydrocephalus
• Department of Neurological Surgery - Neurological Institute
  http://cpmcnet.columbia.edu/dept/nsg/PNS/Hydrocephalus.html
• NINDS - Hydrocephalus Fact Sheet
  http://www.ninds.nih.gov/health_and_medical/pubs/hydrocephalus_fs.htm