What Is Hydrocephalus?

The brain continuously produces cerebrospinal fluid, which circulates around the brain and spinal cord before being absorbed. When this flow is blocked or absorption is impaired, fluid builds up inside the brain's ventricles, causing them to enlarge and compress surrounding brain tissue. This is called hydrocephalus — literally meaning "water on the brain."

Who Is Affected?

Hydrocephalus can occur in newborns and infants (often congenital), in adults following a stroke, brain hemorrhage, infection, or tumor, and in elderly patients as a form of normal pressure hydrocephalus. Symptoms differ by age group but often include headache, vomiting, vision changes, cognitive decline, difficulty walking, and loss of bladder control.

Diagnosis

Diagnosis is confirmed by brain MRI or CT scan, which shows enlarged ventricles. Clinical evaluation is essential to determine the cause, the type of hydrocephalus, and the most appropriate surgical approach.

VP Shunt Surgery

A ventriculoperitoneal (VP) shunt is the most common surgical treatment for hydrocephalus. A thin tube is placed inside the brain's ventricle and connected to the abdominal cavity, allowing excess CSF to drain and be absorbed naturally. Dr. Mesbah Uddin Ahmed regularly performs VP shunt insertion for both pediatric and adult patients.

Endoscopic Third Ventriculostomy (ETV)

In selected cases, ETV — an endoscopic procedure — offers an alternative to shunt surgery. A small opening is made in the floor of the third ventricle using a thin endoscope, allowing CSF to bypass the obstruction and drain naturally without a permanent implant. This is particularly effective for obstructive hydrocephalus and avoids the long-term risks associated with a shunt.