Adult-Onset Hydrocephalus

Hydrocephalus is a neurological disorder in which there is excessive accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain. Most forms of hydrocephalus are the result of obstructed CSF flow in the ventricular system which may be caused by a birth defect, hemorrhage, viral infection, meningitis, a tumor, or head injury.

In adults, symptoms of hydrocephalus include severe nausea and vomiting, migraine-like headaches, lethargy, difficulty waking or staying awake, seizures, visual impairment, irritability, and tiredness.

Two forms of hydrocephalus -- hydrocephalus ex-vacuo and normal pressure hydrocephalus (NPH) -- occur most commonly in adults. Hydrocephalus ex-vacuo occurs when there is damage to the brain caused by stroke or injury, and there may be an actual shrinkage of brain substance. In old age or in individuals with Alzheimer's disease the entire brain may shrink and the CSF increases to fill up the space created by the shrinkage.

NPH is caused by a gradual blockage of the CSF draining pathways in the brain. Although the ventricles enlarge, the pressure of the CSF remains within normal range. NPH is characterized by memory loss (dementia), gait disorder, urinary incontinence and a general slowing of activity.

Due to the multiple underlying disorders and conditions which result in hydrocephalus, there is often no permanent cure. The most effective treatment is the surgical insertion of a shunt-a flexible, artificial tube-into the ventricular system of the brain to divert the flow of CSF into another area of the body, where the CSF can drain and be absorbed into the bloodstream.

The prognosis of hydrocephalus is determined by the cause, the presence or absence of associated anomalies, and the timeliness of diagnosis and treatment. In some cases of NPH in which a shunt has been inserted to remove the excess fluid, the function of the brain may recover and the dementia may be reversed.

Information provided by the
National Institute of Neurological Disorders and Stroke,
National Institutes of Health

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.