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 healthcare provider drains the fluid and protects the brain. Common treatments are described on this sheet. The baby stays in the neonatal intensive care unit (NICU) during treatment.
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 medicine
Your healthcare provider may prescribe medicine 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 healthcare provider may do one of the procedures described below.
Procedures to draw off fluid
The following are possible procedures:
A 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 healthcare provider may also do a spinal tap if your baby’s body is making too much CSF. Your healthcare provider 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 healthcare provider places a device similar to a rubber stopper into your baby's skull. This allows access to the ventricle. A healthcare 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 healthcare provider places inside your baby's brain. The tube is connected to a catheter (thin, flexible tube) that is tunneled through the body to the stomach. The shunt draws fluid off the brain. The fluid then travels through the catheter and drains into the stomach, where it is soaked up 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, the underlying cause, and treatment success. Talk to your healthcare provider about how your baby is likely to progress. Many children diagnosed with the disorder benefit from rehabilitation therapy and educational intervention and go on to lead normal lives with few limitations. Treatment by an interdisciplinary team of medical professionals, rehabilitation specialists, and educational experts is critical for a positive outcome. Left untreated, progressive hydrocephalus may be fatal.
April 20, 2018
Benign External Hydrocephalus: A Review, with Emphasis on Management. Zahl, SM. Neurosurgical Review. 2011;34(4):s417-32., Hydrocephalus in children: clinical features and diagnosis, Up To Date, McAllister, JP., Pathophysiology of Congenital and Neonatal Hydrocephalus, Journal of Fetal and Neonatal Medicine (2012)
Fetterman, Anne, RN, BSN,Shelat, Amit, MD