{"id":151838,"date":"2026-10-21T12:02:29","date_gmt":"2026-10-21T10:02:29","guid":{"rendered":"https:\/\/institutchiaribcn.com\/hidrocefalia\/"},"modified":"2026-11-12T13:32:56","modified_gmt":"2026-11-12T12:32:56","slug":"hydrocephalus","status":"publish","type":"enfermedades","link":"https:\/\/institutchiaribcn.com\/en\/hydrocephalus\/","title":{"rendered":"Hydrocephalus"},"content":{"rendered":"

Last update: 10\/21\/2026, Dr. Miguel B. Royo Salvador<\/a>, Medical License Number 10389. Neurosurgeon and Neurologist.<\/strong><\/p>\n

Definition <\/strong><\/h2>\n

Cerebrospinal fluid (CSF)<\/strong> is a clear, colourless fluid that circulates around the brain and spinal cord<\/strong>, protecting the central nervous system (CNS). It is found in the cerebral ventricles<\/strong>, cavities located within the brain, and also in the subarachnoid space that surrounds the brain and spinal cord.<\/p>\n

\"\"\u00a0Fig. 1 Left image: brain with normal CSF circulation. Right image: brain with hydrocephalus.<\/em><\/p>\n

CSF performs important functions, such as protecting the brain and spinal cord, cushioning impacts, and contributing to the balance of the environment in which the cells of the nervous system function<\/strong>. Under normal conditions, it is continuously produced and reabsorbed, maintaining a relatively stable volume and pressure (Fig. 1, left image<\/em>).<\/p>\n

Hydrocephalus<\/strong> is a neurological condition that occurs when there is an alteration in the circulation, production, or reabsorption of CSF, which can lead to its excessive accumulation within the<\/strong> brain ventricles<\/strong>. As a result, the ventricles may enlarge, and in some cases, intracranial pressure may increase<\/strong> (Fig. 1, image on the right)<\/em>.<\/p>\n

Hydrocephalus can occur at any age and may arise from various causes, presenting in different types and with diverse clinical manifestations. Consequently, its diagnosis and treatment depend on the individual’s age, the underlying cause of the CSF accumulation, and the specific characteristics of each case.<\/p>\n

Symptoms <\/strong><\/h2>\n

Symptoms of hydrocephalus<\/strong> can appear acutely or develop progressively. Clinical manifestations vary depending on the individual’s age<\/strong>, the cause of the hydrocephalus, and the rate at which cerebrospinal fluid accumulates.<\/p>\n

During pregnancy:<\/strong><\/p>\n

In some cases, hydrocephalus can be detected before birth via prenatal ultrasound, which may reveal enlarged cerebral ventricles<\/strong> in the fetus.<\/p>\n

In infants and young children:<\/strong><\/p>\n

One of the most characteristic signs is an increase in head circumference that occurs more rapidly than expected for the child’s age<\/strong>, as the skull bones have not yet fully fused. Other symptoms may include irritability, drowsiness, vomiting, feeding difficulties, or the so-called “setting-sun sign” <\/strong>in which the eyes appear to be directed downward.<\/p>\n

In children:<\/strong><\/p>\n

Symptoms of hydrocephalus <\/strong>may include headaches, nausea, vomiting, and visual disturbances. <\/strong>Depending on the cause and progression of the condition, there may also be behavioural changes, drowsiness, or difficulties with school performance.<\/p>\n

In adolescents and young adults:<\/strong><\/p>\n

Symptoms may include persistent headaches, visual disturbances, dizziness, problems with balance and coordination, difficulty walking, nausea, episodes of loss of consciousness (syncope), and impairments in memory or other cognitive functions. <\/strong><\/p>\n

In adults and older individuals:<\/strong><\/p>\n

Symptoms may primarily affect gait and balance, <\/strong>cognitive functions, and bladder control. Possible manifestations include difficulty walking or standing, slowed movements, memory and concentration issues, a decrease in interest or initiative, and altered urinary control. <\/strong><\/p>\n

It is important to note that not everyone with hydrocephalus experiences the same symptoms<\/strong>. The intensity and progression of these manifestations depend on several factors, including the age of onset, the underlying cause of the hydrocephalus, and the speed at which it develops. In the presence of consistent symptoms, a medical evaluation is necessary to determine their potential origin.<\/p>\n

Furthermore, Hochstetler et al. (1) describe, in general, a clinical picture characterized by \u201cdisorientation and pain (headaches), cognitive and developmental changes, vision and sleep disturbances, and gait abnormalities.\u201d<\/p>\n

Diagnosis<\/strong><\/h2>\n

Kahle et al. note that \u201cBeyond infancy, hydrocephalus typically presents with a constellation of findings that include some combination of headache, vomiting, loss of developmental milestones, diplopia (usually from a VI cranial nerve palsy), or papilloedema<\/strong>.\u201d<\/p>\n

Following a neurological examination with these findings<\/strong>, a specialist may order \u201cbrain imaging<\/strong>\u2014the most important diagnostic tool\u201d (2)\u2014which includes:<\/p>\n

– ultrasonography<\/strong>,
\n– computed tomography (CT)<\/strong>,
\n– magnetic resonance imaging (MRI)<\/strong>.<\/p>\n

Magnetic resonance imaging (MRI)<\/strong> is generally indicated to clarify the anatomy and determine the cause of the hydrocephalus. It is preferred over computed tomography (CT)<\/strong> because MRI avoids radiation exposure and provides a greater amount of information.<\/p>\n

Cine-MRI<\/strong> (or a cine-MRI study of CSF flow<\/strong>) can provide information regarding patient-specific changes in cerebrospinal fluid dynamics<\/strong>.\u201d (2)<\/p>\n

In adults, additional procedures may include lumbar puncture, continuous lumbar CSF drainage, intracranial pressure monitoring, a lumbar infusion test (to measure CSF outflow resistance), or radionuclide cisternography<\/strong>.<\/p>\n

Types<\/strong><\/h2>\n

Hydrocephalus<\/strong> can be classified based on the circulation of cerebrospinal fluid (CSF), its underlying cause, and the time of onset.<\/p>\n