Hydrocephalus (Greek ὕδωρ – water and κεφαλή – head) – excessive accumulation of cerebrospinal fluid in the ventricular system of the brain, characterized by  its impaired outflow, absorption, less often hyperproduction.

Neoplasms of the pituitary gland or parasellar structures are often accompanied by obstructive or less commonly associated hydrocephalus.

Obstructive hydrocephalus manifests itself in blockade of the cerebrospinal fluid tract proximal to arachnoid granulations; the reported form of hydrocephalus is characterized by blockade of liquor circulation at the level of arachnoid granulations.

Differential diagnosis of hydrocephalus

  • Hydrocephalus ex vacuo is not true hydrocephalus; it occurs as a result of brain atrophy during normal aging or from various diseases (Alzheimer’s disease, etc.);
  • Hydranencephaly – a pathology characterized by the filling of the cerebral cavity with cerebrospinal fluid, as a result of the underdevelopment of the neural plate, with normal development of the bones of the cranial vault and the meninges;
  • Agenesis of the corpus callosum;
  • De Morsier syndrome – septooptic dysplasia;

Treatment of hydrocephalus

The main method of treating obstructive hydrocephalus is surgical. The aim of treatment is to reduce intracranial pressure and normalize neurological functions. At this stage, various types of shunting operations are most often used (abduction of an excessive amount of cerebrospinal fluid from the ventricles of the brain):

  • Ventriculoperitoneal shunting (VPS) – removal of cerebrospinal fluid from the lateral ventricle of the brain into the abdominal cavity;
  • Ventriculo-bypass shunting (VBS) – discharge of cerebrospinal fluid from the lateral ventricle of the brain to the right atrium;
  • Torkildsen shunt – discharge of cerebrospinal fluid from the lateral ventricle to the cerebellar cerebral cistern;

Other types of surgical interventions, such as lumboperitoneal shunting, ventriculopleural shunting, etc., can also be used in various situations.


  • Shunt blockage;
  • Disconnection or breakage of the shunt system in the junctions;
  • Shunt infection;
  • Erosion of the shunt system through the skin, etc.