Review of the Treatment & Management of Hydrocephalus

Jacqueline Groat, PharmD Candidate; Joshua J. Neumiller, PharmD, CDE, CGP, FASCP


US Pharmacist. 2013;38(3):HS-8-HS-11. 

In This Article

Abstract and Introduction


In hydrocephalus, a disease or anatomical defect causes an increase in the amount of cerebrospinal fluid (CSF) present in the cranium, which most commonly results in increased pressure against the brain tissue. Hydrocephalus is difficult to diagnose because of its varied signs and symptoms, which commonly overlap with those of other medical conditions. There are generally two approaches to the treatment of hydrocephalus: 1) shunt placement and 2) endoscopic third ventriculostomy (surgical creation of an opening in the floor of the third ventricle to enable the passage of CSF). The treatment of hydrocephalus often requires long-term care and lifelong follow-up, especially in children and neonates in whom there is a congenital cause.


Hydrocephalus is a condition in which a disease state or defect causes an increase in the amount of cerebrospinal fluid (CSF) present in the cranium, most commonly resulting in increased pressure against the brain tissue.[1] The word hydrocephalus translates to "water on the brain," but the condition is caused by a variety of disorders and disease states, thus making it complex to define and diagnose.[1] Most CSF is produced by the choroid plexus in the third and fourth ventricles in the brain.[2] It fills the subarachnoid spaces, protecting and cushioning the brain.[2] As more CSF is produced, it runs from the brain to the spinal cord and is removed from circulation via the arachnoid villi and the vertebral venous plexus.[2] When hydrocephalus occurs, part of this process is blocked, although different parts are blocked depending upon the type of hydrocephalus. Causes range from obstructions to congenital diseases (Table 1).[1,3–5]