Hydrocephalus

What Is Hydrocephalus?

Hydrocephalus is a condition in which cerebrospinal fluid (CSF) accumulates excessively in the cavities (ventricles) of the brain, increasing pressure within the skull. This pressure can damage brain tissue and impair neurological development. In children, it may be congenital (present at birth, often associated with spina bifida or brain malformations) or acquired (following infection, haemorrhage, or tumour).

Symptoms

In infants, the most characteristic sign is rapid increase in head circumference. Other symptoms include a bulging fontanelle, downward deviation of the eyes ("sunset sign"), irritability, vomiting, and feeding difficulties. In older children, headache, visual disturbances, nausea, and cognitive changes are more prominent.

Treatment and the Role of Rehabilitation

The primary treatment is surgical — either ventriculoperitoneal (VP) shunting to drain excess CSF, or endoscopic third ventriculostomy (ETV) to create an alternative drainage pathway. However, surgery addresses fluid accumulation; rehabilitation is essential to manage the neurological effects and support developmental outcomes:

• Developmental Physiotherapy: Motor milestones — head control, rolling, sitting, standing, walking — are supported through targeted exercise and handling techniques according to the child's developmental level.
• Cognitive Rehabilitation: Attention, memory, visual-perceptual, and executive function difficulties are addressed with structured cognitive exercises and educational strategies.
• Speech and Language Therapy: Language development, articulation, and communication skills are monitored and treated from early age.
• Occupational Therapy: Fine motor skills, hand function, and school-related tasks (writing, cutting) are worked on to support academic participation.
• Visual Rehabilitation: Children with hydrocephalus frequently have strabismus and visual field deficits; collaboration with ophthalmology is maintained.
• Family Training: Parents are educated about shunt malfunction warning signs, positioning, stimulation activities, and home exercise programmes.

Long-Term Follow-Up

Children with hydrocephalus require lifelong monitoring for shunt function, neurological status, and developmental progress. At ROMMER, each child's programme is updated as they grow to address evolving educational, social, and functional needs.