What is hydrocephalus?

Hydrocephalus — also called “water on the brain ” — is a term used to describe several different problems that cause cerebrospinal fluid (CSF) to build up in or around the brain or to drain improperly. This causes the brain’s ventricles (fluid spaces inside the brain) to enlarge.

This can happen if:

  • a blockage in the brain’s anatomy that stops the fluid from flowing as it should
  • a hemorrhage or infection that causes scarring within the fluid’s pathways
  • a tumor, cyst or other mass that blocks the normal pathways for fluid

Hydrocephalus progresses over time and causes increasing pressure and stretching of tissue in the brain. If this pressure isn’t relieved, it can interfere with normal brain growth and development and lead to permanent damage in the brain.

Hydrocephalus is often congenital, meaning babies are born with it, but older children can also develop it. In some cases, hydrocephalus can develop as a complication of another condition.

How we care for hydrocephalus

The Boston Children's Hospital Hydrocephalus Program has been treating children with hydrocephalus for decades. Boston Children's was the first hospital in the world to treat children with hydrocephalus with shunts. And in the years since, our clinicians have pioneered and refined the use of minimally-invasive surgical techniques to more effectively treat hydrocephalus while reducing the risk of complications.

Our clinicians have extensive experience in treating children, teens and adults with all forms of the condition and can diagnose hydrocephalus before a baby is born.

Our areas of innovation for hydrocephalus

We try to avoid the life-long problems and risks associated with shunt dependence by treating most cases of hydrocephalus with a minimally invasive endoscopic procedure called endoscopic third ventriculostomy (ETV). For infants under age 2, we combine ETV with choroid plexus cauterization (CPC) because we have demonstrated this enhances the likelihood of success for ETV in that age group. Combined, this procedure is called ETV/CPC.