Hydrocephalus (or hydrocephaly) is a condition that can affect any person, at any stage of life. Its name comes from the Ancient Greek words “hydōr” or “water” and  “kephalē” or “head.” First described in medical text by Hippocrates more than 2000 years ago, this condition is defined as an excess of cerebrospinal fluid in the brain ventricles and spinal column. In a body that does not experience hydrocephalus, the amount of cerebrospinal fluid is regulated by being absorbed into the bloodstream. When a person suffers from hydrocephalus, their body produces too much of this fluid to be absorbed. 

The causes of hydrocephalus are many. It can be caused by birth defects, traumatic brain injuries, brain hemorrhages, and even meningitis. Any event that can cause the obstruction (the most common), under absorption, or overproduction of cerebrospinal fluid can result in hydrocephalus. People of any age can experience hydrocephalus, but it is most commonly seen in infants and individuals over the age of 60. With improvements in modern medicine, it can now be treated with a device called a shunt. A shunt is a plastic tube with a one-way valve which is installed in the ventricle system of the brain, and deposits fluid in another part of the body where it can be absorbed by the blood stream, typically in the abdomen. 

Before the invention of the shunt, hydrocephalus could be a fatal and painful condition. In a recent visit to the Museum of Osteology in Oklahoma, our president, Jon Ferry, got to see a pediatric skull of an individual who suffered from an extreme case of the disease. Left untreated in a young individual, the skull can grow to an extreme size.

Early interception of the disease is imperative to preventing its negative outcomes. In infants, symptoms include a bulging soft spot, vomiting, irritability, sleepiness, persistent downward gaze, seizures, and an abnormally large head. Head measurements are an important tool in detecting hydrocephalus, and should be done at every infant’s regular exams. 

In toddlers, these symptoms can expand to include poor coordination and balance, urinary incontinence, lack of appetite, difficulties with vision, and headaches. As the child grows older, and enters school, these symptoms might include delays in reaching developmental milestones, diminished academic performance, and changes in personality. As children enter adulthood, these symptoms can also be seen, as well as declining job performance due to difficulty concentrating or remembering. All of these symptoms can be amplified in the elderly, resulting in urinary incontinence, loss of mobility, and cognitive decline. 

By recognizing these signs early, hydrocephalus can be treated effectively, preventing tragedies like that of the child whose skull resides in the Museum of Osteology.