Hydrocephalus

For family education. This resource is not an individual diagnosis or treatment plan. Discuss concerns with an appropriately qualified professional.

What it means

Hydrocephalus is an abnormal buildup of cerebrospinal fluid within the brain's fluid spaces. It can increase pressure and affect brain function. Some children have developmental difficulties; others have fewer lasting effects. Treatment and ongoing monitoring are essential, including for children who appear well after surgery.

Causes and risk factors

Fluid can accumulate because its flow is blocked, absorption is impaired, or, less commonly, too much is produced. Causes include congenital differences, bleeding associated with prematurity, infection, and tumors. Hydrocephalus may accompany spina bifida or other conditions. Its developmental effects depend on the cause, severity, and course.

Signs and everyday impact

Infants may have unusually rapid head growth, a bulging soft spot, poor feeding, vomiting, sleepiness, or abnormal downward eye positioning. Older children may develop headache, vomiting, balance changes, or reduced alertness. Learning and attention difficulties can occur. A single head-size measurement does not establish the diagnosis.

Assessment and diagnosis

Clinicians review head-growth measurements, symptoms, examination, and brain imaging. Ultrasound may be used in infants with an open soft spot; MRI or other imaging is selected as appropriate. Neurosurgical review determines whether treatment is needed. Developmental assessment identifies communication, motor, and learning supports.

Treatment and therapy

Many children need surgery to divert fluid through a shunt. Endoscopic surgery is an option for selected cases. The neurosurgical team explains follow-up and signs of blockage or infection. Therapy, educational accommodations, and treatment of associated conditions address ongoing needs. A shunt can require later revision, so monitoring continues beyond the initial operation.

Support at home

Keep the neurosurgical team's contact details and emergency instructions readily available. Know the child's usual behavior and promptly report significant changes. Share the shunt or surgical history with other clinicians. Encourage play and movement within the team's advice, and review developmental progress and learning needs over time.

When to seek help

Seek urgent medical help for new persistent vomiting, severe headache, unusual sleepiness, or neurological change, particularly in a child with a shunt. Reduced consciousness or breathing difficulty requires emergency services.

Questions for the care team

• Which symptoms should trigger our shunt emergency plan?
• What follow-up and imaging are planned?
• Which developmental or learning supports are needed?

Terms in plain language

• Cerebrospinal fluid: fluid that surrounds and cushions the brain and spinal cord.
• Shunt: a surgically placed system that diverts fluid.
• Ventricles: fluid-filled spaces inside the brain.

Podcast preparation

Use this resource to prepare a later episode: define the topic, discuss causes and signs, explain assessment, describe treatment and home supports, then close with urgent signs and a next step.

Myth: shunt placement ends the need for follow-up. Fluid diversion systems require ongoing monitoring.

Verify current clinical guidance and obtain clinical review before public recording.

Sources

1. Hydrocephalus | National Institute of Neurological Disorders and Stroke - https://www.ninds.nih.gov/health-information/disorders/hydrocephalus
2. Manage Spina Bifida | Spina Bifida | CDC - https://www.cdc.gov/spina-bifida/treatment/index.html
3. Assessing Developmental Delays in Children - HealthyChildren.org - https://www.healthychildren.org/English/ages-stages/toddler/Pages/Assessing-Developmental-Delays.aspx

Sources accessed 3 October 2026.