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Treatment for Hydrocephalus in the Newborn

Cerebrospinal fluid (CSF) is a fluid that circulates through the brain. Ventricles (chambers) inside the brain make the fluid. Normally, the fluid drains out of the brain through the ventricles and into the spinal column. The body then absorbs the fluid. If CSF backs up into the brain, the problem is called hydrocephalus. The buildup causes the ventricles to swell and puts pressure on other parts of the brain. The head may swell as fluid and pressure build. The pressure can damage brain tissue. In some cases, a doctor drains the fluid and protects the brain. Common treatments are described on this sheet. The baby stays in the neonatal intensive care unit during treatment.

image of normal ventricle inside of brain. image of enlarged ventricle inside of compressed brain.

Causes of Hydrocephalus

Here are the most common causes of treatable hydrocephalus:

  • A blockage in the head prevents CSF from draining.

  • The body has problems absorbing CSF.

  • The body makes too much CSF.

Treating Hydrocephalus with Medication

Your doctor may prescribe medication to slow down the flow of CSF temporarily, until the blockage is gone. If this works, your baby may not need other treatment. If  your baby needs further treatment, your doctor may perform one of the procedures described below. 

Procedures to Draw Off Fluid

  • spinal tap may be done if the opening between your baby's ventricle and spinal cord is partially blocked. The blockage is often due to an intraventricular hemorrhage. The doctor may aso do a spinal tap if your baby’s body is making too much CSF. Your doctor inserts a small needle into your baby's back, into the fluid-filled space surrounding the spinal cord. Some CSF is drawn out with this needle. This may relieve some of the pressure on the ventricle, allowing the rest of the fluid to drain.

  • A ventricular tap may be done if the opening between the ventricle and spinal cord is completely blocked. The doctor places a device similar to a rubber stopper into your baby's skull. This allows access to the ventricle. A health care provider can then draw fluid out of the ventricle with a needle. This may be done as a temporary solution while waiting for the blockage to go away.

  • A ventricular peritoneal (VP) shunt is a tube that your doctor places inside your baby's brain. The tube is connected to a catheter (thin, flexible tube) that is tunneled through the body to the abdomen. The shunt draws fluid off the brain. The fluid then travels through the catheter and drains into the abdomen, where it is absorbed by the body. The shunt and catheter are enclosed under the skin. They can’t be seen from the outside. They’re permanent, but will need to be replaced as the baby grows.

What Are the Long-Term Effects?

Hydrocephalus can affect brain development. Damage may range from mild to severe, depending on prompt diagnosis and treatment success. Talk to your doctor about how your baby is likely to progress.

 

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