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Hydrocephalus in Newborns

Hydrocephalus, also known as “water on the brain,” is caused by a buildup of cerebrospinal fluid (CSF) in the brain’s hollow spaces. These hollow spaces are called ventricles, and CSF buildup in them can lead to excessive pressure on the brain. Seeking treatment is important to lower the fluid buildup and relieve pressure before damage occurs.

Children who experience a blockage of CSF, or a lack of absorption of this fluid, are at risk for developmental and health complications. Prompt treatment is important to reduce any potential long-term damage that can come from hydrocephalus. Good prenatal care may help reduce the potential for problems, but proper care is not a guarantee a child won’t be born with or later develop hydrocephalus.

During pregnancy, an ultrasound performed between 15 and 35 weeks can detect hydrocephalus. There is no treatment for hydrocephalus when a baby is in utero, so observation is the typical recommendation at that time. If the condition worsens as the fetus develops, early delivery may be necessary.

Complications During Treatment

hydrocephalus diagnosis can bring mixed emotions for you as a parent or caregiver. You may be relieved to finally have an answer but feel apprehensive about the journey ahead. While medical advancements have provided effective treatments, it is essential to understand the complications and challenges that can arise after treatment. The following are some of the most common complications:

  • Shunt malfunction: When a shunt implanted to drain excess fluid malfunctions, it can lead to nausea, headaches, and vision problems.
  • Infection: Any surgical procedure has a risk of infection. A shun infection after surgery can be a severe issue.
  • Over-drainage or under-drainage: The shunt can drain too much or too little cerebrospinal fluid, leading to complications.
  • Shunt blockage: If the shunt gets blocked, it can prevent the fluid from draining. A blockage can cause pressure to build up against the brain.

Having a shunt or undergoing endoscopic third ventriculostomy (ETV) is not a one-off solution. It becomes a part of your child’s daily life. You should remain vigilant and aware of potential complications. For example, your child could experience issues if the shunt moves or becomes blocked. Alternatively, children with an ETV could encounter problems if the ventriculostomy closes.

These treatments are often life-saving and can significantly improve your child’s quality of life, but living with a shunt or ETV can lead to complications. Regular check-ups, awareness of warning signs, and access to prompt medical care are critical.

While hydrocephalus in newborns can be challenging, you can navigate treatment issues with the right knowledge and support. Being informed and proactive can help ensure the best possible outcome for your newborn.

Complications of Ventriculoperitoneal (VP) Shunt Surgery

Doctors often use ventriculoperitoneal (VP) shunt surgery to treat hydrocephalus in newborns. Diverting excess fluid from the brain to other body parts—often the belly or chest—helps release pressure inside your newborn’s skull. However, like any surgery, a VP surgery comes with risks:

Shunt malfunction: A primary concern with VP shunts is the risk of malfunction. Possible causes include blockage, mechanical failure, and a shift in the shunt’s position from the child’s growth. When a shunt malfunctions, it fails to effectively drain the buildup of cerebrospinal fluid, which can cause complications.

Infections: Introducing a foreign object like a shunt into your newborn’s system can cause infections. The infections may be localized around the shunt site. However, they can spread and lead to severe complications such as meningitis.

Early detection of complications increases the chances of a positive outcome. You should remain alert for the following signs and symptoms of VP shunt surgery issues:

  • Abdominal pain: Your child may suffer abdominal discomfort if the shunt drains into the abdomen.
  • Vision changes: Double vision or increased sensitivity to light might indicate increased pressure.
  • Fever: This can indicate an underlying shunt infection.
  • Headaches: These can be a sign of increased intracranial pressure, which could indicate a shunt malfunction.
  • Irritability: This is particularly important to monitor in newborns and younger children who cannot communicate their discomfort.
  • Swelling or redness: Irritation or swelling around the area where the shunt is placed could indicate an infection.
  • Vomiting: This can signify deeper issues, particularly when accompanied by other symptoms, such as irritability.

Although the complications can be intimidating, VP shunt surgeries have transformed the lives of countless children with hydrocephalus. Many of these issues can be managed or prevented with the right care and medical support.

Complications of Endoscopic Third Ventriculostomy (ETV) Surgery

Endoscopic third ventriculostomy (ETV) is another surgical procedure to address hydrocephalus. Unlike the VP shunt, an ETV does not use a shunt. Instead, surgeons create a hole in the bottom of one of the ventricles in the brain to relieve pressure buildup and allow the fluid to flow. While ETV has its advantages, including fewer hospital visits, it has unique potential complications.

Risk of closure: The ventriculostomy closing is a primary concern of ETV. This can occur suddenly and at any time, resulting in an abrupt buildup of fluid and pressure. If this happens, it will require immediate medical attention. The reasons for ETV closure can vary, from the body’s natural healing processes to scar tissue forming. 

Further surgery: If your child’s ETV closes or encounters other complications, they may need another brain surgery to reopen the hole and repair the ETV. 

Being aware of potential problems can lead to better outcomes. Some signs and symptoms of ETV complications include:

  • Enlarged head
  • Severe headaches
  • Lethargy or drowsiness
  • Irritability
  • Vision changes
  • Balance issues
  • Neck stiffness

Prognosis for Hydrocephalus in Newborns

Doctor testing a toy

Every child’s journey with hydrocephalus is unique. Different factors can play a significant role in your child’s prognosis, including:

  • The cause of the hydrocephalus
  • The severity
  • The age of diagnosis
  • The treatments received

Some children need minimal interventions, while others require extensive care. Approaching the situation with an open mind while working closely with health care professionals is essential.

As your child grows and develops, they may need shunt revisions because of a malfunction or infection. Regular medical check-ups can help you detect when a shunt revision may be necessary. 

While these interventions are crucial for your child’s well-being, they can impact development. Brain surgeries can impact cognitive and physical development. 

Hydrocephalus in newborns can also lead to associated conditions. You should be aware of these conditions to ensure early detection:

  • Cerebral palsy
  • Seizures
  • Vision problems
  • Spina bifida
  • Dandy-Walker Syndrome
  • Chiari Malformation
  • Delayed speech
  • Eye-hand coordination impairments
  • Delayed motor developments

Despite the many challenges of hydrocephalus, advancements in medical science and effective treatments can help your child pursue their passions and lead a fulfilling, happy life.

Doctors operating a pregnant woman

How Can Parents Help Their Newborn With Hydrocephalus?

Your child’s emotional and psychological well-being significantly depends on the parental support they receive. Your love, patience, and understanding can make a world of difference. By advocating for your child’s needs and providing a nurturing environment, you encourage their growth and strengthen their resilience.

Being proactive about your child’s care is important. Regular physician check-ups are crucial. As your child grows, their treatment plan may need to change. 

Adhering to medical recommendations is also essential. Ensure your child consistently takes prescribed medications as directed.

Therapy and rehabilitation also play a key role in enhancing your child’s quality of life. Examples of therapies that can benefit your child include:

  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Cognitive therapy
  • Behavioral therapy

The type of therapy your child will benefit from will depend on their unique needs. Health care professionals can help determine the best therapies for your child.

Educating yourself about hydrocephalus in newborns allows you to make better decisions for your child. By staying informed, being proactive, and seeking the best therapeutic interventions, you ensure that your child has the best chance of a fulfilling life despite the challenges caused by hydrocephalus.

If you believe a medical professional’s negligence caused your newborn’s hydrocephalus, you may be entitled to compensation. Contact us today to schedule your free case review.

Written by:
Birth Injury Center Team

The Birth Injury Center aims to create informational web content and guides to help women and their families seeking support and guidance for birth injuries caused by medical negligence. All of the content published across The Birth Injury Center website has been thoroughly investigated and approved by medical expert Natalie Speer, RNC-OB, Attorney Ryan Mahoney, and Attorney Rick Meadows.