Hydrocephalus (Water On The Brain) : Causes, Types, Symptoms, & Treatment

Hydrocephalus (Water On The Brain) : Definition, Causes, Types, Signs, Symptoms, Diagnosis, Treatment, Shunt, & Prognosis


  • Hydrocephalus refers to the increase in head size due to increase in CSF volume & increase in ventricular size of brain.


1. Obstructive (Non communicating)

  • Site of pathology: Formation of CSF till exit from 4th ventricle.

2. Non-obstructive (Communicating)

  • Site of pathology: Basal cistern, Subarachnoid space, Absorption by arachnoid villi


1. Obstructive (Non communicating)

  • Most common cause: Congenital aqueductal stenosis associated with NTDS

2. Non-obstructive (Communicating)

  • Most common cause:

World: Subarachnoid haemorrhage (SAH)

India: Tuberculous meningitis > Pneumococcal meningitis

Clinical Features

  • Increase in head size
  • Separation of sutures (1st to separate: Cornonal suture)
  • Bulging of fontanelles
  • No papilloedema


  • Sunset sign


  • Transcranial ultra sound (Ix of choice)


1. Treat the cause

2. Medical

Carbonic anhydrase inhibitors

Decrease CSF production

Not effective in inflammatory conditions

3. Surgical

  • Surgical shunt (Best shunt: V-P shunt Ventriculo peritoneal shunt)

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