Neurosurgery for Children With Hydrocephalus

Learning your infant or child has been diagnosed with hydrocephalus can be a very emotional and overwhelming experience. Neurosurgery offers treatments that are proven effective in the treatment of hydrocephalus, diverting the flow of cerebrospinal fluid (CSF) to avoid build-up in the brain.

What is Hydrocephalus

Hydrocephalus is a condition in which excess CSF (cerebrospinal fluid) can build up in or around the ventricles of the brain. Hydrocephalus can be present at birth (congenital) and sometimes symptoms won’t show up until later in a person’s life. Thought to be a combination of environmental and genetic factors, hydrocephalus has many known causes. If it is acquired later in life, it can result from head injury, disease, such as meningitis, or a brain tumor. The most common cause of congenital hydrocephalus is stenosis – an obstruction of the cerebral aqueduct – a channel that allows cerebrospinal fluid (CSF) to pass between the third and fourth ventricles in the brain.


Symptoms of hydrocephalus can vary. The most obvious sign is an enlargement of the baby’s head and/or a bulging of the soft spot (fontanel). Other symptoms to look for include loss of appetite, vomiting, seizures, sleepiness (although this is hard to determine in an infant), and downward movement of the eyes caused by the extra pressure in the brain cavity.


In addition to a thorough neurological examination by your doctor, imaging is taken to confirm the diagnosis. An infant may receive an ultrasound, which is a simple, painless procedure that passes sound waves through the infant’s open fontanel (the soft spot). Older children will have a CT/CAT scan, which uses an x-ray beam to produce images on a computer; or an MRI, which doesn’t use x-ray but rather radio signals and a powerful magnet. Both are painless procedures. A child may receive a sedative before an MRI to avoid movement that can blur images. You must bring these scans with you when you go to see the neurosurgeon.

Neurosurgery to Treat Children With Hydrocephalus

There are two main treatments for hydrocephalus, both of which involve minimally invasive endoscopic surgery.

Shunt Placement

The most common type of treatment involves the placement of a small shunt (plastic tube) that helps to drain the excess CSF from the brain to another part of the body. A common placement type is called a ventriculoperitoneal shunt, which drains into the abdominal cavity. Shunt placement has numerous benefits, including the fact that it’s been around the longest and is a proven effective treatment option.

ETV (Endoscopic Third Ventriculostomy)

ETV is a more recent innovation to treat hydrocephalus. In this procedure, a small incision is made at the bottom of one of the ventricles in the brain. This incision allows CSF to drain.


Hydrocephalus is common, affecting 1 out of every 1,000 babies born. It is also the most common reason for brain surgery in children. Fortunately, there are relatively short, painless and uncomplicated neurosurgical procedures that are proven effective treatments for hydrocephalus in infants and children. Your neurosurgeon will explain the best surgical procedure for your child’s circumstances.

If you are looking for a neurosurgeon in the Hudson Valley region of New York State, click the link to learn more about the board-certified, award-winning neurosurgeons of Hudson Valley Brain & Spine Surgery.