Hydrocephalus, also known as "water on the brain," is a medical condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain. This may cause increased pressure inside the skull and progressive enlargement of the head.
Hydrocephalus may begin while the baby is growing in the womb. It is common in babies who have a myelomeningocele, a birth defect in which the spinal column does not close properly. 

Hydrocephalus in infants may also be due to genetic defects and certain infections that may occur during pregnancy.
In young children, hydrocephalus may result from infections, bleeding in the brain, brain injury, tumors of the brain or spinal cord, and trauma.

Hydrocephalus most often occurs in children, but may also occur in adults and the elderly.


In infants with hydrocephalus, cerebrospinal fluid builds up in the central nervous system (the brain and spinal cord), causing the fontanelle (soft spot) to bulge and the head to be larger than expected.  Early symptoms may include eyes that appear to gaze downward, irritability, seizures, separated sutures, sleepiness, and vomiting.
Symptoms may include the following:
  • brief and shrill cry
  • changes in personality
  • changes in memory or the ability to reason or think
  • changes in facial appearance
  • crossed eyes or uncontrolled eye movements
  • difficulty eating
  • excessive sleepiness
  • headache or irritability
  • loss of bladder control
  • loss of coordination
  • trouble walking
  • increased muscle tone 
  • vomiting
Hydrocephalus is a progressive condition, meaning that symptoms will worsen over time. If a child’s hydrocephalus is not addressed, the pressure inside their brain will increase, blood flow can become dangerously restricted to the brain, and tissues in his nervous system (brain and spinal cord) can sustain serious damage.

As a result, for most children with hydrocephalus, more involved treatments—usually the placement of a shunt, an endoscopic third ventriculostomy procedure (ETV) or a combined endoscopic third ventriculostomy/choroid plexus cauterization procedure (ETV/CPC)— eventually become necessary.


Physical Therapy is an integral part of the hydrocephalus multi-disciplinary team. The physical therapist performs testing of function, balance, and gait disturbances typical of a patient with hydrocephalus.


Physical Therapy will address common secondary difficulties associated with hydrocephalus such as strengthening, stretching, neuromuscular re-education, balance training, development of gross motor skills such as walking, and increased independence with functional daily tasks.
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