This document presents a case of hydrocephalus in a 10-week-old baby boy. The baby was diagnosed with hydrocephalus prenatally via ultrasound and MRI scans, which showed an excess of cerebrospinal fluid in the brain ventricles. After birth, the baby exhibited symptoms of hydrocephalus including a large head, bulging soft spot, poor feeding, and seizures. Treatment included an endoscopic third ventriculostomy to reduce fluid and medications to control seizures. The baby will require monitoring of epilepsy and fluid levels, and may need a shunt placed if fluid builds up again in the future. Hydrocephalus can affect learning abilities long-term if not properly treated.

1. HYDROCEPHALUS
CASE PRESENTATION BY STACEY PALMER

2. Patient is a baby boy with gestational age 48
weeks, and chronological age 10 weeks.
Delivered at 38 weeks due to water on the brain

3. Patient’s history:
Abnormal ultrasound while in utero
Fetal MRI showed extra CSF in ventricles
Diagnosed with Hydrocephalus
Induced at 38 weeks
.

4. Symptoms after birth:
• Large head
• Bulging soft spot
• Slow response to
touch
• Irritability
• Poor feeding
• Seizures

5. After Birth:
• Ultrasound-showed excess
fluid in the ventricles
• MRI showed blockage
between the ventricles,
which was causing the
buildup-known as
noncommunicating
hydrocephalus
• EEG was done-spike
activity present

6. Treatment:
 Endoscopic third ventriculostomy to reduce
fluid
 Started the baby on Phenobarbital to help
control the seizures
 Follow up in a month to see if seizures are
controlled/check on fluid levels in brain

7. Future plans/treatment:
Monitor epilepsy with future EEGs
Check CSF level in ventricles with
ultrasound and MRI
If there is more build up, a shunt will be
surgically placed
Learning disabilities/help

8. Shunts:
Placed in the third ventricle and goes down
to stomach usually
Can cause more seizures
Risk of infection
Future replacements

9. Types of Hydrocephalus:
Blockage in CSF tract outside of ventricles-Communicating
Blockage inside the ventricles-Non-Communicating
Causes:
Genetic abnormality
Birth defects, like spina bifida
Head trauma during birth
Infection during pregnancy that causes brain swelling
Acquired Hydrocephalus:
Occurs in any age, due to meningitis, stroke, brain/spinal cord
tumors

10. Outcomes of hydrocephalus:
Some recover just fine and there are no long
lasting symptoms
There might be severe learning disabilities as
well, time will tell
Epilepsy treatment and medications

11. Questions?
1. Can hydrocephalus be diagnosed before the baby is
born?
2. What are the two treatment options?
3. What are the risk to placing a shunt?
4. Can hydrocephalus occur in adults?
5. Can hydrocephalus affect learning abilities?

12. Sources:
https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-
sheets/hydrocephalus-fact-sheet
https://pubmed.ncbi.nlm.nih.gov/3245943/
https://www.researchgate.net/figure/Fetal-MRI-at-32-weeks-of-gestation-
showing-huge-hydrocephalus-due-to-aqueduct-stenosis-by_fig5_51652248