Hydrocephalus in Infants

What Is Hydrocephalus in Infants?

Hydrocephalus in infants — also called “water on the brain” — happens when cerebrospinal fluid builds up around the brain or isn’t able to drain properly.

CSF buildup can happen if:

• Blockage in the brain stops CSF from flowing properly
• Scarring caused by infection or a hemorrhage blocks CSF pathways
• Cysts or tumors block CSF pathways

Hydrocephalus in infants is one of the most common brain disorders to affect children. According to Stanford Children’s Health, about 1 in 500 babies is born with hydrocephalus, and each year another 6,000 children develop it before they turn 2 years old.

What Is Cerebrospinal Fluid?

CSF is a bodily fluid made inside the brain’s ventricles that provides cushioning to the brain and spinal cord by flowing around them. It also provides nutrients and removes waste from the brain. CSF is then absorbed into the bloodstream and replaced by new fluid.

Types of Hydrocephalus in Infants

1. Communicating hydrocephalus: Develops when not enough CSF is absorbed into the bloodstream
2. Obstructive hydrocephalus: Develops when the brain’s CSF flow is blocked

Hydrocephalus Causes and Risk Factors

Hydrocephalus is usually congenital, meaning that babies are born with the condition. However, hydrocephalus in infants and children can develop after birth as well.

There is no single cause of hydrocephalus, but some possible causes include:

• Birth injuries
• Bleeding in the brain
• Brain tumor or lesion
• Infection during pregnancy
• Infection in the brain
• Meningitis
• Premature birth
• Spina bifida
• Spinal cord injury
• Traumatic head injury

In some instances, hydrocephalus in infants can be the result of head trauma during the birthing process. If a baby becomes stuck, forceps or vacuum extractors may be needed, and improper use of these devices may cause harm to a baby. In these instances, medical negligence could be at play.

Symptoms of Hydrocephalus in Infants

Symptoms of hydrocephalus can vary widely and depend on a child’s age and how advanced the condition is.

Signs of hydrocephalus in infants include:

• Bulging eyes and difficulty looking up when facing forward
• Extreme tiredness
• High-pitched cry
• Irritability/fussiness
• Large head size
• Poor feeding
• Projectile vomiting
• Rapid increase in head size
• Seizures with no known cause
• Severe and frequent vomiting
• Soft spots on the head that may bulge
• Visible scalp veins

Older children with hydrocephalus may experience:

• Balance and coordination problems
• Blurred or double vision
• Delays in reaching developmental milestones
• Difficulty standing or walking
• Loss of bladder control
• Memory and focus challenges
• Nausea and vomiting
• Severe headaches
• Sudden personality change

Hydrocephalus symptoms often mimic symptoms of other conditions. Therefore, it is extremely important to talk with your child’s health care provider without delay if any of the above symptoms develop.

Diagnosing Hydrocephalus in Infants

Hydrocephalus usually begins to develop in the third trimester of the mother’s pregnancy. When a baby is still in the womb, fetal ultrasound is used to diagnose hydrocephalus.

Additionally, hydrocephalus in infants and older children is usually diagnosed in one of three ways: ultrasound, computed tomography (CT scan), and magnetic resonance imaging (MRI).

Ultrasound

Ultrasounds use sound waves to create images of the inside of the body. During pregnancy, an ultrasound can show ventricle size in a baby’s brain. Ultrasounds can also be performed after a baby is born.

CT Scans

Computed tomography uses X-rays to make detailed images of any part of a baby’s body, including bones, fat, muscles, and organs.

MRI

Magnetic resonance imaging combines large magnets and radio waves to show detailed images of organs inside a baby’s body.

Complications from Hydrocephalus in Infants

It is difficult to predict what complications may arise from hydrocephalus in infants. Since it injures the brain, hydrocephalus may cause epilepsy, learning disabilities, vision problems, coordination issues, short-term memory loss, and early onset of puberty. Additionally, complications from surgery and shunts used to treat hydrocephalus in infants may arise.

These complications may include:

• Bleeding
• Infection
• Too much/not enough fluid drainage

In milder cases, or in instances where treatment was highly successful, hydrocephalus in infants may lead to completely normal development.

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Treatment Options for Hydrocephalus in Infants

There is currently no treatment for hydrocephalus during pregnancy. Instead, a baby will be monitored carefully for signs of distress while still in the womb. If problems are detected, early delivery may be required.

Once a baby is delivered, treatment will depend on symptoms, general health, and the severity of the condition. However, hydrocephalus in infants typically needs to be treated with surgery.

Surgical options for hydrocephalus in infants include:

• Ventriculoperitoneal (VP) shunt surgery: Shunt placement is the most common treatment for hydrocephalus in infants. A shunt is a thin and flexible tube that is placed in the brain or spinal cord to drain CSF. Shunts need to be adjusted and replaced over time and must be monitored by a neurosurgeon.
• Endoscopic third ventriculostomy (ETV): This may be an option for older children. It is minimally invasive and creates an opening for trapped CSF to escape into its natural pathways.
• Combined endoscopic third ventriculostomy/choroid plexus cauterization (ETV/CPC): This procedure can be used in most cases of hydrocephalus in infants. It is believed to both reduce the rate of CSF production and also provide new pathways for CSF to escape.

Hydrocephalus in infants usually gets worse over time and increases the levels of pressure in the brain. If the pressure isn’t relieved, it can lead to permanent damage to the brain.

Compensation for Hydrocephalus in Infants Related to Medical Negligence

The key to treating hydrocephalus in infants is early diagnosis. A shunt is usually needed, which means your child will need regular checkups to monitor how it is working. The shunt will also need to be adjusted regularly as your child grows.

While treatment for hydrocephalus in infants is usually successful, most children need multiple surgeries and ongoing medical care.

If you believe your child’s hydrocephalus was caused due to medical negligence, legal support and financial compensation may be available to you.

Contact the Birth Injury Justice Center to consult with our experienced team of Patient Advocates and get a free legal case review.