Brain Injury Newsroom

A Brain Scan Using Radioisotopes May Show Abnormalities Of The Fluid Pathway

When a physician taps fingertips on the skull, there may be abnormal sounds associated with thinning and separation of skull bones. Scalp veins may appear dilated.

The circumference of the entire head may be large, or only part of the head may be enlarged, most commonly the frontal area. Head circumference measurements, repeated over time, may show progressive enlargement.

The eyes may be depressed, with a "setting-sun" sign where the sclera (white portion of the eye) is visible above the iris (colored portion of the eyes). A neurologic examination may show specific deficits, and reflexes may be abnormal for the age of the child.

The following tests may be performed:

Transillumination of the head (shining a light against the head) may show abnormal fluid accumulation in various areas of the head.
A head CT scan is one of the best tests for identifying hydrocephalus.
A spinal tap and examination of the CSF may be performed (rarely).
Skull x-rays show thinning and/or separation of skull bones and enlargement of the skull.
A brain scan using radioisotopes may show abnormalities of the fluid pathway.
An arteriography may show causes of hydrocephalus related to the brain's blood vessels.
An echoencephalogram, a form of ultrasound of the brain, may show dilated ventricles caused by hydrocephalus or intraventricular bleeding.
This disease may also alter the results of a RHISA scan.

The goal is to reduce or prevent brain damage by improving the flow of CSF.

Surgery is the main treatment. The obstruction may be surgically removed, if possible. If the obstruction cannot be removed, a shunt may be placed within the brain to allow CSF to bypass the obstructed area.

Shunting CSF to an area outside the brain (such as the right atrium of the heart or the abdominal peritoneum) is an alternative to shunting within the brain. Removing or cauterizing (destroying by burning) the parts of the brain that produce CSF may (theoretically) reduce CSF production.

Antibiotics are usually used aggressively with any sign of infection. Severe infections may require the shunt to be removed.

Follow-up examinations generally continue throughout the child's life to evaluate the child's developmental level and to treat any intellectual, neurologic, or physical problems.

Visiting nurses, social services, support groups, and local agencies can provide emotional support and assist with the care of the child with hydrocephalus who has significant brain damage.

Expectations (prognosis)    Return to top