Hydrocephalus can feel overwhelming — whether you’re a parent noticing concerning signs in an infant, an adult navigating new neurological symptoms, or a caregiver supporting an aging loved one. The encouraging reality is that with prompt diagnosis and the right neurosurgical team, hydrocephalus is highly treatable, and most patients go on to lead full, active lives. At Princeton Brain, Spine & Orthopedics, we guide Mercer County families through every step of the journey, from imaging and diagnosis to advanced surgical care and long-term management.
Our fellowship-trained neurosurgeons have spent decades diagnosing and treating hydrocephalus across every stage of life — from infants with congenital cases to older adults with normal pressure hydrocephalus. Through PBSO’s affiliations with leading hospitals across New Jersey and Eastern Pennsylvania, our surgeons perform shunt placement and minimally invasive endoscopic third ventriculostomy (ETV) using state-of-the-art technology. Patients, families, and referring physicians across the region trust PBSO for precise diagnosis, clear guidance, and surgical outcomes built on nearly two decades of specialty neurosurgical experience.
Abnormal Fluid Accumulation
Hydrocephalus, or “water on the brain,” is a condition caused by a buildup of cerebrospinal fluid (CSF) in the skull. In a healthy person, CSF circulates around the brain and spinal cord, supplying nutrients, removing waste, cushioning the brain, and regulating brain pressure. In a patient with hydrocephalus, the normally free circulation of CSF and its re-absorption by the bloodstream is disrupted. Fluid begins to accumulate in the brain’s ventricles, increasing pressure on brain tissue.
Hydrocephalus Symptoms
While hydrocephalus can occur at any age, it is most common in infants, young children, and adults over age 60.
Symptoms in Infants
Because the skull bones of infants are not yet closed, the symptoms of hydrocephalus often show up as visible signs of pressure, including:
- Enlarged head
- Tense or bulging soft spot
- Thin scalp with prominent veins
- Separated bones in the head
Infants may also exhibit physical and behavioral symptoms, including:
- Drowsiness
- Poor appetite
- Constant downward gaze
- Vomiting
- Irritability
- Seizures
Symptoms in Toddlers & Young Children
Young children with hydrocephalus often show these same symptoms, along with additional indications:
- Headache
- Fever
- Delayed progress
- Poor coordination
- Inability to concentrate
- Loss of sensory or motor functions
Symptoms in Older Children & Adults
When hydrocephalus affects older children and adults, the skull bones are unable to spread when brain pressure increases. Resulting symptoms include:
- Headache
- Nausea & vomiting
- Impaired vision
- Bladder control problems
- Loss of coordination & balance
- Changes in concentration & memory
Diagnosing the Condition
Diagnosis of hydrocephalus begins with a complete physical and neurological exam to detect problems of brain function. Sophisticated imaging tests like MRI, CT scan, and ultrasound (for infants) are then used to detect obstructions and determine the severity of hydrocephalus. On rare occasions when other tests fail to reveal the cause of the disease, a transducer is inserted to measure intracranial pressure.
Treatments for Hydrocephalus
If hydrocephalus is not creating symptoms, or if it is due to a temporary obstruction, treatment may consist of monitoring the condition instead of intervening. In most cases, however, hydrocephalus is treated with surgery. The type of surgery depends on the cause of the condition and its severity.
When hydrocephalus is the result of a tumor or cyst blocking the flow of cerebrospinal fluid, removal of the obstruction is the best course of action. If the obstruction cannot be surgically removed, treatment involves surgery to divert the flow of CSF and avoid increased brain pressure. Diversion is not a cure for the condition, but it can alleviate symptoms and allow for satisfactory long-term management of hydrocephalus.
Surgical Diversion Methods
Shunt surgery: Short and relatively uncomplicated, this procedure inserts a small, flexible plastic tube into the ventricle passages in the brain and sends excess CSF into another area of the body where it can safely be absorbed. Although shunt surgery is effective for treating hydrocephalus, there are drawbacks. Shunts can malfunction, clog, become infected, or be outgrown by children, requiring replacement surgery.
Ventriculoscopy (ETV): A relatively new, minimally invasive procedure, ETV involves insertion of a tiny telescopic camera (an endoscope) into the ventricle to view the fluid and locate the obstruction. The surgeon then creates a small opening in the membrane at the bottom of the ventricle, allowing CSF to detour around the obstruction and flow freely into the rest of the brain for re-absorption.
Successful ETV avoids the need for a shunt and has a lower long-term complication rate than shunt surgery. However, the procedure is not recommended for children under two. Ventriculoscopy is more complicated than shunt surgery and requires a neurosurgeon specially trained in endoscopic techniques.
Why Choose PBSO for Hydrocephalus Care
PBSO neurosurgeons are at the forefront of surgical innovation and are trained and experienced in advanced techniques like ventriculoscopy. Through our association with leading NJ and PA hospitals, we also have access to state-of-the-art surgical facilities and equipment. Our compassionate, patient-focused practice provides patients with the knowledge they need to make informed healthcare decisions.
Ready to talk with a hydrocephalus specialist? Call Princeton Brain, Spine & Orthopedics today at (888) 741-7272 or contact PBSO online to schedule a consultation with one of our neurosurgical providers.
