Neurosurgery - Patient Care and Treatment

Learn about hydrocephalus causes, symptoms and treatments from the Penn State Children’s Hospital Pediatric Neurosurgery team.

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What is Hydrocephalus and how is it treated?

Quick answers from, Mark Dias, MD, Director, Pediatric Neurosurgery, Penn State Children’s Hospital.

You can learn more about Dr. Dias here:


Hydrocephalus is often diagnosed at birth or shortly after, but sometimes it’s not diagnosed until the child is a little older.

Sometimes ultrasounds or magnetic resonance imaging (MRI) can detect hydrocephalus in utero, before the baby is born.

Symptoms of hydrocephalus

In an infant, the most obvious sign of hydrocephalus is an unusually large head. Also:

  • The soft spot (fontanel) may be tense and bulging.
  • The scalp may appear thin and glistening.
  • The scalp veins may appear to have unnatural fullness (prominence).
  • When you feel your baby's head along the suture lines, you may find that the bones are separated.

Symptoms to watch for are:

  • Vomiting
  • Sleepiness
  • Irritability
  • Downward turn of the baby's eyes (the sunsetting sign)

Toddlers whose sutures have not yet closed also show the signs of head enlargement. Older toddlers and children, once their sutures have closed, will show other symptoms of raised intracranial pressure (ICP) caused by their enlarged ventricles. Often these symptoms include:

  • Headache
  • Nausea
  • Vomiting
  • Blurred or double vision
  • Balance problems
  • Delayed walking or talking
  • Poor coordination

As with infants, a child may be more irritable or tired than normal. The child may show a change in personality or be unable to concentrate or remember things. School performance may decline. Older children may have trouble waking up and staying awake. While at times the symptoms are very noticeable, other times they can be very subtle and progress so slowly you may not notice them until you look back over time.

Causes of hydrocephalus

A variety of medical problems can cause hydrocephalus. In many children, the problem is there at birth (congenital). Most cases of congenital hydrocephalus are thought to be caused by a complex interaction of genetic and environmental factors.

  • Hydrocephalus that develops later in life in some children, and even in adults, may be caused by a condition that existed at birth. This is still considered a form of congenital hydrocephalus.
  • Acquired hydrocephalus develops after birth and is caused by things such as:
    • Head injury
    • Meningitis
    • Brain tumor

If your child has hydrocephalus, don’t blame yourself. In almost all cases, the causes are out of your control.

Our hydrocephalus care team:

* Dr. Dias, Dr. Iantosca, and Dr. Rizk  are members of the Hydrocephalus Association

Our locations for hydrocephalus diagnosis and treatment