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Hearing that your baby has fluid building up around the brain can be frightening, especially when you do not yet know why it is happening or what it could mean for your child.
Hydrocephalus occurs when cerebrospinal fluid (CSF) builds up in the brain's ventricles. As the fluid accumulates, it can enlarge the ventricles and put pressure on brain tissue. The causes of hydrocephalus in newborns range from conditions that develop before birth to bleeding, infections, and injuries that occur around the time of delivery or afterward.
For parents, finding the cause can answer more than a medical question. If hydrocephalus developed after a preventable complication or doctors failed to recognize signs that a baby needed treatment, there may also be questions about the medical care your child received.
If you have concerns about how your baby's hydrocephalus developed or was treated, call Thorsnes Bartolotta McGuire at (619) 236-9363 or contact us online for a free consultation.
Hydrocephalus develops when CSF cannot circulate or be absorbed normally. Less commonly, the brain produces too much CSF. The result is more fluid inside the ventricles than the brain can properly manage.
A baby can be born with hydrocephalus or develop it after birth. According to Children's Hospital of Philadelphia, pediatric hydrocephalus can be associated with birth differences such as spina bifida, bleeding in the brain, infections, head injuries, tumors, or cysts.
Here are some of the reasons it develops in babies.
1. A Blockage in the Brain Prevents Fluid From Flowing
CSF normally travels through passageways in and around the brain before being absorbed. If one of those pathways is too narrow or blocked, fluid can collect behind the obstruction.
Aqueductal stenosis is one example. It involves narrowing of the cerebral aqueduct, a small passage connecting ventricles within the brain. The condition can develop before birth and cause the ventricles to enlarge as CSF accumulates.
Other structural differences in the brain can interfere with normal CSF flow as well.
2. Spina Bifida or Another Condition Develops Before Birth
Hydrocephalus is strongly associated with some congenital conditions, including myelomeningocele, the most serious form of spina bifida.
The CDC explains that many babies born with spina bifida develop hydrocephalus because brain fluid cannot drain normally. The accumulating fluid can enlarge the ventricles and put pressure on the brain.
Other congenital brain abnormalities, including Chiari malformations and Dandy-Walker malformation, can also interfere with CSF circulation.
These causes of hydrocephalus in newborns begin during fetal development and generally are not the result of medical negligence. However, prenatal imaging can sometimes identify enlarged ventricles before birth, giving the medical team time to evaluate the condition and plan the baby's care after delivery.
3. Bleeding Occurs in or Around the Brain
Bleeding in the brain is an important cause of acquired hydrocephalus in newborns, especially premature babies.
Intraventricular hemorrhage, or IVH, occurs when bleeding develops in or near the brain's ventricles. More severe bleeding can produce blood clots that interfere with the normal flow of CSF, leading to hydrocephalus.
Premature babies face a higher risk because blood vessels in their developing brains are fragile. Hydrocephalus associated with brain bleeding can require close monitoring and, in some cases, surgery to drain the excess fluid.
Questions about a possible child injury can arise when brain bleeding is connected to trauma or another potentially preventable event rather than complications of prematurity or an underlying medical condition.
4. An Infection Interferes With CSF Drainage
Infections involving the brain and surrounding tissues can disrupt the way CSF circulates or is absorbed.
Meningitis is one example. Inflammation and scarring caused by the infection can interfere with the pathways responsible for moving and absorbing CSF. Certain infections during pregnancy can also affect fetal brain development and contribute to congenital hydrocephalus.
For newborns, prompt recognition and treatment of a serious infection are especially important because their condition can deteriorate quickly.
5. A Brain Injury Occurs Before, During, or After Birth
Trauma and brain injury can cause bleeding or swelling that interferes with CSF circulation. MedlinePlus lists injury before, during, or after childbirth among the potential causes of hydrocephalus in young children.
The presence of hydrocephalus after delivery does not by itself establish that something went wrong during childbirth. Doctors have to determine why the fluid accumulated and whether another condition, bleeding event, or injury caused it.
When the medical history points to a potentially preventable injury, parents may want a medical malpractice attorney to examine the prenatal, labor and delivery, and neonatal records.
A baby's skull has not fully fused, so increasing pressure can cause the head to grow unusually quickly. Parents or doctors may first notice that the baby's head circumference is increasing faster than expected.
Other hydrocephalus symptoms in babies can include:
- A bulging or firm soft spot on the head
- Vomiting
- Poor feeding
- Unusual sleepiness
- Irritability
- Seizures
- Eyes that appear fixed downward, sometimes called "sunsetting eyes"
- Separated skull sutures
These signs warrant medical attention. Doctors can use head measurements, physical examinations, ultrasound, MRI, or CT imaging to investigate suspected hydrocephalus.
If you are trying to understand whether your baby's hydrocephalus was an unavoidable medical condition or connected to the care surrounding birth, call Thorsnes Bartolotta McGuire at (619) 236-9363. Our attorneys can examine the medical records and the events leading up to the diagnosis.
Parents searching does hydrocephalus go away in babies may be hoping that the excess fluid will resolve as their child grows. Hydrocephalus usually requires medical monitoring and often treatment to relieve the pressure caused by excess CSF.
A common treatment is a shunt, a tube surgically placed to drain excess fluid from the brain to another area of the body where it can be absorbed. Some children are candidates for endoscopic third ventriculostomy (ETV), which creates another pathway for CSF to flow.
Children's Hospital of Philadelphia notes that hydrocephalus is usually a lifelong condition requiring continued care. Some children need additional procedures if a shunt becomes blocked, infected, or needs replacement as they grow.
Many babies develop hydrocephalus for reasons no doctor caused. A congenital brain abnormality, spina bifida, or complications associated with extreme prematurity can occur despite appropriate medical care.
A hospital negligence or birth injury investigation looks instead at what happened before and after the hydrocephalus developed.
Potential concerns could include a failure to respond to abnormal prenatal imaging, inadequate monitoring of a premature infant at risk for brain bleeding, a delay in diagnosing or treating a serious infection, or failure to investigate signs of increasing pressure inside the baby's skull.
For example, repeated head measurements showing unusually rapid growth could call for further evaluation. A bulging fontanelle, vomiting, feeding problems, unusual sleepiness, seizures, or other neurological changes can also prompt testing.
If those signs are missed and treatment is delayed, excess pressure can continue affecting the developing brain.
The timing of diagnosis can be just as significant as the underlying cause. Hydrocephalus puts pressure on the brain, and treatment is aimed at relieving that pressure and preventing further injury.
A legal investigation may require records from pregnancy, labor and delivery, the NICU, pediatric appointments, imaging studies, and later neurological care. Medical experts can then evaluate when signs of hydrocephalus first appeared, what the baby's providers knew, and whether appropriate testing or treatment should have occurred sooner.
Parents who discover a possible birth injury months or years later can also have questions about how long they have to pursue a claim. Our guide to how late you can sue for a birth injury in California explains the deadlines that can apply.
Get Answers About Your Baby's Hydrocephalus
A hydrocephalus diagnosis does not tell parents why it happened. Understanding whether the condition developed before birth, followed a brain bleed or infection, or appeared after another complication can be an important step in understanding your child's medical history.
Thorsnes Bartolotta McGuire has represented families in complex medical malpractice and serious injury cases for decades.
If you have questions about the care your baby received before hydrocephalus was diagnosed, call (619) 236-9363 or contact us online for a free consultation. We can investigate when the condition developed, how the medical team responded, and whether earlier care could have prevented additional injury.
