Hydrocephalus:

This is an abnormal accumulation of cerebrospinal fluid within the skull. It can be associated with ventricular dilatation and increased intracranial pressure. Hydrocephalus (“water on the brain”) in the pediatric and adult population, for the most part, presents for different reasons. Congenital hydrocephalus (1/1000 births) is often associated with other conditions such as spina bifida. Rarely is hydrocephalus secondary to overproduction but rather an interruption of flow or absorption of CSF.

Simple classification for hydrocephalus is communicating vs. non-communicating, with the latter secondary to masses or abnormalities which prevent CSF from getting through the ventricular system.

For children older than 2-3 years of age the sutures for the most part are closed and therefore the skull is rigid. Younger than this age group allows for head expansion although the workup for both adults and the pediatric age group require thorough investigation. The treatment can involve the placement of a shunt (ventriculo-peritoneal or ventriculo-atrial), removal of the lesion causing the problem and in some cases an endoscopic third ventriculostomy.

The adult cases of hydrocephalus are usually more straight-forward than the pediatric age group.