Hydrocephalus: Causes, Symptoms, and Treatment
Written by Achuta Uppu, MD. Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hydrocephalus?
A neurosurgeon, a surgeon who operates on the brain and nerves, usually treats hydrocephalus. A neurologist, a doctor who treats brain and nerve conditions, is often part of the care team too. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is hydrocephalus?
Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) deep within the brain. CSF protects and cushions the brain and spine. The extra fluid makes the ventricles, which are cavities within the brain, widen. This puts harmful pressure on the brain's tissues.
It may be present at or shortly after birth, or it may result over time from damage or injury. It can happen in children and adults. It is also called water on the brain.
Symptoms
Symptoms can vary a lot from person to person and mostly depend on age. In infants, signs may include:
- A rapid increase in head size or an unusually large head.
- A bulge on the soft spot (fontanel) on the top of the head.
- Vomiting, problems feeding, sleepiness, or irritability.
- Eyes that are fixed downward, called sun setting.
- Seizures.
Older children and adults may have:
- Headache, nausea, or vomiting.
- Blurred or double vision.
- Problems with balance or poor coordination.
- Loss of bladder control.
- Changes in personality, memory loss, or trouble thinking.
- Problems walking, often described as feet feeling stuck.
Causes and who gets it
Hydrocephalus is due to a problem with the flow of the fluid that surrounds the brain. CSF can build up if the flow is blocked. It can also build up if the blood does not absorb it well, or if the brain makes too much of it.
Babies may be born with hydrocephalus, called congenital hydrocephalus. Causes can include inherited genetic abnormalities that block the flow of CSF, and complications of premature birth such as bleeding within the ventricles. An infection during pregnancy, such as rubella, can also be a cause.
At any age, risk can rise with brain or spinal cord tumors. Infections such as bacterial meningitis also raise the risk. So does an injury or stroke that causes bleeding in the brain.
Normal pressure hydrocephalus (NPH) causes problems with walking, bladder control, and thinking. It is most common in older adults. It can be hard to diagnose because the symptoms are similar to those of more common conditions, such as Alzheimer's disease. Unlike Alzheimer's disease, NPH symptoms can be relieved with treatment.
How doctors diagnose it
A doctor will do a neurological exam. The doctor will also order brain imaging and other tests. Ultrasound is often the first test for infants. MRI (magnetic resonance imaging) is usually the first test for children and adults.
In babies, repeated head size measurements over time may show that the head is getting bigger.
Treatment
The most common treatment for hydrocephalus is surgery. In one option, a doctor places a shunt, which is a tube, in the brain to drain the extra fluid so the body can absorb it. Another option is endoscopic third ventriculostomy. It improves the flow of CSF out of the brain.
Shunts require monitoring and regular medical checkups. Shunts generally work well, but they can stop working or lead to infection. A person may need multiple surgeries to repair or replace a shunt throughout their lifetime.
Many people also benefit from rehabilitation therapies and educational support. Care by a team of medical professionals, rehabilitation specialists, and educational experts is critical to a positive outcome.
When to see a doctor
Seek medical care right away if your child has any symptoms of hydrocephalus. Call 911 or go to the emergency room if a child has extreme drowsiness or sleepiness, a seizure, severe headache, stiff neck, vomiting, fever, trouble breathing, feeding problems, a high-pitched cry, or no pulse. Adults should call 911 for fainting, trouble breathing, confusion, or being hard to wake.
People with a shunt should get medical help right away if signs suggest it is not working. These signs include headache, nausea, double vision or sensitivity to light, soreness of the neck or shoulder muscles, and redness or tenderness along the shunt tract. Hydrocephalus symptoms coming back are also a warning sign.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can notice early warning signs, order a first round of tests, and help coordinate your neurosurgery and follow-up care.
Common questions
Can hydrocephalus be treated?
Yes. The most common treatment for hydrocephalus is surgery, using a shunt or an endoscopic third ventriculostomy. While the success of treatment varies from person to person, some people recover almost completely after treatment and have a good quality of life.
Is hydrocephalus the same as water on the brain?
Yes, water on the brain is an older name for hydrocephalus. The brain is not surrounded by water but by a fluid called cerebrospinal fluid.
Can adults get hydrocephalus?
Yes, hydrocephalus can happen in children and adults. Normal pressure hydrocephalus is most common in older adults.
Does a shunt last forever?
No, a shunt may need to be repaired or replaced. Shunts generally work well, but they can stop working or lead to infection.
Can hydrocephalus be prevented?
Some steps may lower the risk. Protecting the head of an infant or child from injury is one step.
Sources
- National Institute of Neurological Disorders and Stroke - Hydrocephalus
- MedlinePlus - Hydrocephalus
- NHS - Hydrocephalus
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
