February 6, 2025
Hydrocephalus is often thought of as a childhood condition, but it can also affect adults — sometimes developing slowly and going unrecognized for years. When left untreated, hydrocephalus can significantly impact mobility, cognition, and quality of life. Early diagnosis and proper treatment are key.
This guide explains what hydrocephalus is, how it presents in adults, and the treatment options available.
Hydrocephalus occurs when there is an abnormal buildup of cerebrospinal fluid (CSF) within the brain's ventricles. CSF normally cushions the brain and spinal cord, delivers nutrients, and removes waste. When the balance between CSF production and absorption is disrupted, fluid accumulates, increasing pressure inside the skull. Over time, this pressure can damage brain tissue and interfere with normal neurological function.
Communicating Hydrocephalus
CSF flows between ventricles but is not properly absorbed into the bloodstream. This type often develops after brain injury, infection, or hemorrhage.
Non-Communicating (Obstructive) Hydrocephalus
A blockage prevents CSF from flowing freely through the ventricles. Tumors, cysts, or structural abnormalities are common causes.
Normal Pressure Hydrocephalus (NPH)
A form of communicating hydrocephalus most often seen in older adults. Despite normal pressure readings, fluid buildup causes symptoms that can resemble other neurological conditions.
Symptoms may develop gradually or appear suddenly, depending on the cause.
Cognitive and Behavioral Changes
Gait and Balance Issues
Urinary Symptoms
Additional Symptoms
The classic symptom triad of gait disturbance, cognitive decline, and urinary incontinence is especially characteristic of normal pressure hydrocephalus.
Hydrocephalus can result from a variety of conditions, including:
In some cases, particularly with NPH, no clear cause is identified.
Accurate diagnosis requires a combination of clinical evaluation and imaging.
Medical History and Neurological Exam
Doctors assess symptom patterns, balance, coordination, reflexes, and cognitive function.
Imaging Studies
Diagnostic Tests
Treatment depends on the type and cause of hydrocephalus, as well as symptom severity.
Ventriculoperitoneal (VP) Shunt
The most common treatment involves surgically placing a shunt to divert excess CSF from the brain to another area of the body, usually the abdomen, where it can be absorbed.
Endoscopic Third Ventriculostomy (ETV)
In select cases, surgeons create a small opening in the ventricle to allow CSF to flow more freely, reducing the need for a shunt.
Ongoing Monitoring
Some patients require long-term follow-up to adjust shunt settings or monitor for complications. Early treatment often leads to significant improvement, particularly in walking and balance.
Hydrocephalus symptoms can mimic other conditions such as Alzheimer's disease, Parkinson's disease, or general aging. Misdiagnosis may delay effective treatment. When properly identified and treated, many adults experience meaningful improvements in mobility, cognition, and independence.
Adults should seek evaluation if they experience:
A specialist evaluation can help determine whether hydrocephalus or another neurological condition is responsible.
Bottom line: Hydrocephalus in adults is a treatable neurological condition when diagnosed early. Understanding the symptoms, causes, and treatment options empowers patients and families to seek timely care and improve long-term outcomes.