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Playing Hydrocephalus Explained

The Doctors discuss the story of Roona, a 3-year-old girl in India who was born with hydrocephalus, a disorder that causes fluid to build up in the brain. Roona’s condition became so severe that her skull swelled to 94 centimeters in circumference, roughly three times the normal size for a child her age. 

After five surgeries, including a shunt surgery to help drain the built-up fluid, Roona’s head is still larger than average, but she can hold her head up and can move it from side to side on her own. Her doctor, neurosurgeon Dr. Sandeep Vaishya, says it is unclear whether she will lead a normal life, but her progress is promising.

Neurosurgeon Dr. Neil Martin joins The Doctors to explain how this condition develops, and why it is so dangerous.

“We’re lucky in the United States that we almost never see this extreme sort of case,” Dr. Martin says. “I’ve never seen a case like this. They’re more common in developing countries, where they don’t have great pediatric care.”

What is hydrocephalus?

Hydrocephalus is the accumulation of cerebrospinal fluid – the fluid that normally bathes the brain and spine – in the ventricles deep within the brain. When the normal circulation of this fluid is blocked, the excess fluid builds up, causing the ventricles to swell and put pressure on the brain. Excessive pressure can damage the brain tissue and result in a variety of impairments in brain function.

Typically caused by a tumor, Dr. Martin explains that this condition also can arise from an intracranial hemorrhage. Though most common among infants and older adults, hydrocephalus can occur at any age.

He adds that in adults, this condition can become life-threatening within hours due to the rigidity of the cranial bones. In infants, the skill isn’t fully fused yet and therefore can expand with the swelling of the ventricles.

Common symptoms

Pediatrician Dr. Jim Sears shares the signs and symptoms of hydrocephalus in infants:

  • Increase in the size of the head or a bulging fontanel (soft spot) on the top of the head
  • Lethargy
  • Trouble eating
  • Downturn in development, including deficits in muscle tone and strength, responsiveness to touch and expected growth

Additional symptoms among toddlers and children include:

  • Headache
  • Impaired vision
  • Nausea or vomiting
  • Poor coordination and/or unstable balance
  • Seizures

In older adults, the common symptoms include:

  • Incontinence or a frequent urge to urinate
  • Memory loss
  • Decline in thinking or reasoning skills
  • Poor coordination and balance, and difficulty walking
  • Slow movements


The most common treatment for hydrocephalus is the surgical insertion of a shunt to allow the fluid to flow out of the ventricles and into another part of the body that can more easily absorb the excess fluid, such as the abdomen.

Source: The Mayo Clinic