Hydrocephalus

Hydrocephalus is a term applied to conditions where there is disturbance in cerebrospinal fluid (CSF) dynamics. These are often, but not necessarily, associated with enlarged cerebral ventricles and increased intracranial pressure. Hydrocephalus could be idiopathic or secondary to congenital or acquired conditions. Clinical presentation depends on the age of presentation, with paediatric hydrocephalus presenting with increased head circumference or features of raised intracranial pressure. In the elderly, normal pressure hydrocephalus is a specific entity that presents with a classical triad of gait, cognitive and continence impairment. Urgent neurosurgical management of acute hydrocephalus is often required. The main method of treatment is surgical, mostly by inserting a CSF drainage shunt. These are catheters that divert CSF to a body cavity, with an embedded valve mechanism to control drainage. Unfortunately shunt complications are common. Recognizing a shunt complication and early referral to a neurosurgical unit is important to prevent serious consequences to the patient.