Hydrocephalus (Water on the Brain) Treatment Options

The team at the Brain Care Institute at Children's Hospital of Pittsburgh of UPMC works hard to provide treatment, education, and guidance as each baby grows and develops. Our main goal for children with hydrocephalus is to determine the underlying cause of hydrocephalus, if present, and to promptly treat both the hydrocephalus and the reason for its development before irreversible changes in the brain occur.

A team of specialists will determine if medications or additional procedures should be used. The key to caring for hydrocephalus in infants is early detection and treatment, and prevention of infection through frequent medical evaluations.

How Do Doctors Treat Hydrocephalus (Water on the Brain)?

For many children with hydrocephalus, surgery is needed. This may involve placing a shunt, which is a device used to help drain the extra CSF from the brain and redirect the extra fluid to another part of the body. A common type of shunt is the ventriculoperitoneal shunt. Insertion of the ventriculoperitoneal shunt is done under general anesthesia, which at Children’s is administered by pediatric anesthesiologists who specialize in treating children.

The shunt consists of three parts:

  • A tube that is placed inside of the ventricular space
  • A reservoir and valve to control the flow of CSF
  • Tubing that is directed under the skin to the abdomen or, less commonly, to the heart or lung area

Some children with certain types of hydrocephalus can be treated successfully in a minimally invasive manner through endoscopic intraventricular surgery. An endoscope is used to create bypass channels for fluid to flow around an area of obstruction (as in an endoscopic third ventriculostomy or an endoscopic septostomy) or to directly treat an obstructing lesion, such as endoscopic cyst fenestration.

Risks of Hydrocephalus Surgery

Hydrocephalus can affect a child’s brain and development. The extent of the problem depends on the severity of the hydrocephalus, and whether brain or other organ system problems exist.

Although the benefits of these surgeries usually outweigh the risks, potential complications can arise, including:

  • Infection
  • Shunt malfunction, resulting in underdrainage or overdrainage of the CSF
  • Bleeding
  • Fever
  • Vomiting
  • Irritability
  • Redness
  • Swelling along the area of the tubing
  • Decreased alertness or lethargy

These complications require prompt medical evaluation. Following surgery, the family will receive instructions on how to care for the baby at home, and information about signs or symptoms requiring medical care.