What are possible complications of hydrocephalus?

Updated: Jun 04, 2018
  • Author: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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See the list below:

  • Related to progression of hydrocephalus

    • Visual changes

      • Occlusion of posterior cerebral arteries secondary to downward transtentorial herniation

      • Chronic papilledema injuring the optic disc

      • Dilatation of the third ventricle with compression of optic chiasm

    • Cognitive dysfunction

    • Incontinence

    • Gait changes

  • Related to medical treatment

  • Related to surgical treatment

    • Signs and symptoms of increased intracranial pressure (ICP) can be a consequence of undershunting or shunt obstruction or disconnection.

    • Subdural hematoma or hygroma is secondary to overshunting. Headache and focal neurological signs are common.

    • Treat seizures with antiepileptic drugs.

    • Shunt infection occasionally can be asymptomatic. In neonates, it manifests as alteration of feeding, irritability, vomiting, fever, lethargy, somnolence, and a bulging fontanelle. Older children and adults present with headache, fever, vomiting, and meningismus. With ventriculoperitoneal (VP) shunts, abdominal pain may occur.

    • Shunts can act as a conduit for extraneural metastases of certain tumors (eg, medulloblastoma).

    • Hardware erosion through the skin occurs in premature infants with enlarged heads and thin skin who lie on 1 side of the head.

    • VP shunt complications include peritonitis, inguinal hernia, perforation of abdominal organs, intestinal obstruction, volvulus, and CSF ascites.

    • Ventriculoatrial (VA) shunt complications include septicemia, shunt embolus, endocarditis, and pulmonary hypertension.

    • Lumboperitoneal shunt complications include radiculopathy and arachnoiditis.

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