Hydrocephalus is a condition in which cerebrospinal fluid (CSF) accumulates excessively in the spaces called ventricles in the brain and increases intracranial pressure.

Cerebrospinal fluid is produced in the brain in chambers called ventricles and in ball-like structures called choroid plexus. It passes through these chambers, circulates around the brain and spinal cord, and is absorbed into the vein from tissues called arachnoid villi on the brain surface.

CSF circulation has 3 main effects:

Reducing the harmful effects of impacts with its shock absorbing effect on the brain and spinal cord within the skull and spine.

Helping nourish the brain and transport waste

Circulating between the brain and spinal cord to regulate pressure changes

What are the symptoms of hydrocephalus?

Hydrocephalus symptoms vary according to age groups.

For babies aged 0-2 years:

Growth around the head because the skull is not yet fully mature,

Tension and enlargement of the fontanelle,

Thinning of the scalp, prominent veins,

Crying in a high pitched voice,

View of the setting sun with the eyes directed downwards,

Loss of appetite, weakness, vomiting, restlessness

In children aged 2-6 years:

abnormal enlargement of the head

Headache, nausea, vomiting,

Restlessness, insomnia, loss of appetite

Balance disorders, delay in walking or speaking

Double or blurred vision

Urinary incontinence, epileptic seizures

For school children over 6 years of age:


Loss of appetite, vomiting and weight loss

Absentmindedness, forgetfulness, decrease in school performance, difficulty in learning

Visual disturbances, imbalance

In adults:


Attention and concentration impairment, poor memory

Problems with bladder control, urinary incontinence

balance disorders

Visual and judgment disorders that may affect business life

In the elderly:

Forgetfulness and memory loss

Coordination and balance disorders and resulting difficulty in walking

Problems with bladder control, urinary incontinence

Diagnosis of Hydrocephalus

Evaluation with detailed medical history and physical examination

Ultrasound (USG) (in babies with open fontanelles)

With computed tomography (CT) and Magnetic Resonance (MR) examinations

With these methods, hydrocephalus is diagnosed by showing signs of enlargement of the ventricles and increased pressure in the brain.

Hydrocephalus Treatment

In order to solve the problem of hydrocephalus, a surgical procedure can be performed to remove the cause of the obstruction or to reintroduce the excessively accumulated fluid into the circulation.

The most commonly used method in the treatment of hydrocephalus is to direct the excess fluid accumulated in the brain to another place with a silicone tube drainage system called shunt.

Shunt systems

Shunt systems include a catheter tube placed in the ventricle of the brain, a valve-pump system that allows fluid flow in one direction, and a long catheter tube passed under the skin and placed in the intra-abdominal cavity or the vein leading to the heart.

Pressure controlled, current controlled, programmable etc. There are various shunt systems such as: Which shunt system to choose is determined according to the patient’s problems and the physician’s preference.

Endoscopic third ventriculostomy

It is a method that can be applied in obstruction-type hydrocephalus in which CSF absorption is normal but develops due to stenosis or obstruction in CSF circulation. In this method, a window is opened at the base of the 3rd ventricle with the endoscope, allowing the obstruction to be bypassed and the CSF to reach the place where it will be absorbed without a shortcut.

Problems That May Occur Due to Shunt

Although the shunt system solves the problem, it is not a perfect method. Problems may occur over time.

Shunt Failure to Work: Chemical substances in the CSF, tissue residues, clots, and infection may block the shunt.

Shunt Rupture-Separation: Microtraumas etc. There may be ruptures or displacements at the catheter connection points.

Excessive Excretion: Headaches may develop due to excessive excretion due to increased pressure while standing. To prevent this, antisiphon device reinforced shunts have been developed. Due to excessive CSF discharge, the brain spaces shrink and shrink, the space between the meningeal membrane and the brain widens, and the bridging veins there may stretch and bleed.

Shunt Infection: Since the shunt system is ultimately a foreign material to the body, it is easier for microbes to settle here. Signs and complaints such as meningitis-like findings, fever, headache, loss of appetite or vomiting, abdominal pain, restlessness, and seizures may be observed due to infection. Infection on the skin may appear as redness and discharge along the shunt path.