This is probably the most common pediatric neurosurgical condition. The causes may vary. Hydrocephalus may generally be due to obstruction in the the circulation, insufficient reabsorption or overproduction of cerebrospinal fluid. It is often necessary to divert the cerebrospinal fluid circulation by placing a valve. The fluid can then drain into the abdomen, or more rarely into a large vein, and from there to the heart or to the chest, between the lungs and the thoracic wall. Early diagnosis of this condition prevents possible serious neurological problems that can be life threatening for the child. Sometimes the diagnosis is made before birth, with ultrasound during pregnancy. Although it is usually a benign condition, sometimes the valve can become blocked or infected, and the increased intracranial pressure could be life-threatening. Early diagnosis and decompression can be life saving.
Symptoms of increased intracranial pressure are vomiting, headache, dizziness, drowsiness, and the fundoscopy may reveal papilledema, an important sign of increased intracranial pressure. The valve may need repair on numerous occasions during the child’s lifespan. Modern imaging methods such as cine-MRI may give us new information about the pathophysiology of hydrocephalus.