Hydrocephalus & VP Shunt: A Complete Patient Guide

By Dashvanth Healthcare Medical Team · Reviewed by our specialists · East Delhi

What Is Hydrocephalus?

Hydrocephalus is an abnormal accumulation of cerebrospinal fluid (CSF) in the brain's ventricles, causing them to enlarge and increase pressure on the brain. CSF normally circulates around the brain and spinal cord, providing cushioning and nutrient transport. In hydrocephalus, this balance is disrupted.

Causes

• Congenital (present at birth) — aqueductal stenosis, spina bifida
• Acquired — after meningitis, brain haemorrhage, tumour, or head injury
• Normal Pressure Hydrocephalus (NPH) — elderly patients: classic triad of dementia, walking difficulty, urinary incontinence

Symptoms

• Infants: enlarging head circumference, bulging fontanelle, downward eye deviation ("sunset sign")
• Older children and adults: headache (worse in morning), vomiting, visual blurring, cognitive decline, gait disturbance

Diagnosis

CT or MRI brain shows enlarged ventricles. Additional tests (tap test, ICP monitoring) for NPH.

Treatment: VP Shunt

Ventriculoperitoneal (VP) shunt is a thin tube system diverting CSF from the brain's ventricles to the abdominal cavity, where it is absorbed. It is a highly effective, well-established procedure. Modern programmable shunts allow non-invasive pressure adjustment.

Endoscopic Third Ventriculostomy (ETV)

An alternative to shunting for obstructive hydrocephalus — a small hole is made in the floor of the third ventricle, allowing CSF to bypass the blockage. No implanted hardware — advantageous in younger patients.