Hydrocephalus Program

A national leader in the care management of children with hydrocephalus

Our team of doctors and nurses has decades of experience caring for children with complex neurological disorders requiring surgery.

The Hydrocephalus Program at Nicklaus Children's Hospital is a national leader in the care management of children with hydrocephalus. The program, which was one of the first in North American to use minimally invasive endoscopic techniques to treat premature babies with post-hemorrhagic hydrocephalus, has among the nation's longest experience with this method. For some patients, endoscopic third ventriculostomy with choroid plexus coagulation can offer a permanent resolution of hydrocephalus without the need for placement of a shunt.

The Hydrocephalus Program is under the leadership of the Division of Pediatric Neurosurgery at Nicklaus Children's Hospital, part of the nationally recognized Nicklaus Children's Neuroscience Institute. The team of doctors and nurses has decades of experience caring for children with complex neurological disorders requiring surgery, and has championed pioneering and innovative techniques for managing children with epilepsy, brain tumors, spasticity and hydrocephalus.

Caring for Infants and Children of All Ages

Many babies are diagnosed with hydrocephalus before birth. Consultations with the Hydrocephalus Program care team prior to birth optimizes care planning and helps expectant families understand their child's diagnosis, helping them be more at ease.

What is Hydrocephalus?

Hydrocephalus is primarily an excessive accumulation of fluid in the brain. This excess of fluid, known as cerebrospinal fluid (CSF), accumulates in the brain, causing the fluid spaces of the brain to enlarge. There are many cause of hydrocephalus, which can be congenital or acquired in nature. In some children, the cause remains unknown.

Conditions We Treat

The Hydrocephalus Program offers treatment for hydrocephalus stemming from all causes. Types can include:

Communicating hydrocephalus
Obstructive hydrocephalus
Post-hemorrhagic hydrocephalus
Congenital hydrocephalus

Causes of Hydrocephalus

The most common causes of hydrocephalus include intraventricular hemorrhage in premature babies, spina bifida/myelomeningocele, aqueductal stenosis, meningitis, head injury and brain tumors.

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Treatments and Procedures

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Hydrocephalus Signs and Symptoms

Hydrocephalus symptoms depend on many factors including age, the amount of brain damage and what is causing the buildup of CSF fluid. Some common symptoms of hydrocephalus in babies and older children include:

Enlarged fontanel (in infants)
Vomiting and nausea
Headaches
Lethargy
Irritability
Macrocephaly
Abnormal eye movements

Hydrocephalus Treatment Options

The Hydrocephalus Program team conducts a comprehensive evaluation of each patient, before recommending treatment options tailored to meet the child or infant's individual needs.

Shunt placement

A shunt is a valve that is connected to a catheter to divert excess cerebral spinal fluid to another part of the body for absorption. Our neurosurgeons use various types of shunt valves, both fixed pressure and programmable valves to treat hydrocephalus in babies and children. These options are determined based on each patient's individual needs.

Endoscopic Third Ventriculostomy

Endoscopic third ventriculostomy (ETV) with or without choroid plexus cauterization is a minimally invasive procedure that creates an opening in the floor of the third ventricle to allow free-flowing communication between the ventricular system and the subarachnoid spaces. Through evidence-based research, it has been recognized that adding cauterization of the choroid plexus to the third ventriculostomy has impacted positively the success of ETVs to treat hydrocephalus in young children and certain types of hydrocephalus.

Stories to Inspire

In 2003 a team of medical volunteers, led by pediatric neurosurgeon Dr. John Ragheb, traveled to Haiti to perform surgery for children with hydrocephalus. Hydrocephalus is one of the most common treatable causes of neurological disability and death in the developing world.
The team has developed a comprehensive program in Port au Prince working the local medical community to develop Haiti’s first neurosurgery training program. The team travels regularly to Haiti to teach and help manage children and babies with hydrocephalus, providing care for more than 1,000 children to date in the island nation.