Treatment for Hydrocephalus in the Newborn

Cerebrospinal fluid (CSF) is a fluid that circulates through the brain. This fluid is made by ventricles (chambers) inside the brain. Normally, the fluid drains out of the brain through the ventricles and into the spinal column. The fluid is then absorbed by the body. 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, treatment can be done to drain the fluid and protect the brain. Common treatments are described on this sheet. The baby will stay in the NICU (neonatal intensive care unit) during treatment.

Normally, fluid circulates through the brain and drains out through the ventricle.

With hydrocephalus, fluid backs up into the ventricle.

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

Medication may be prescribed to slow down the flow of CSF. If this works, other treatment may not be needed. If further treatment is needed, one of the procedures described below may be done.

Procedures to Draw Off Fluid

• A spinal tap may be done if the opening between the ventricle and spinal cord is partially blocked. This is often due to an intraventricular hemorrhage (IVH). Or, a spinal tap may be done if the baby’s body is making too much CSF. A small needle is inserted into the 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. A device similar to a rubber stopper is placed in the skull. This allows access to the ventricle. Fluid can then be drawn 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’s placed inside the brain. It’s 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 how severe  the hydrocephalus is. Talk to the doctor about how your baby is likely to progress.