One of the most common conditions associated with encephalocele is hydrocephalus — sometimes called "water on the brain." Understanding it helps you understand a big part of your child's care.
What hydrocephalus is
The brain makes cerebrospinal fluid (CSF) that normally flows around and through the brain and is reabsorbed. In hydrocephalus, fluid builds up, enlarging the fluid spaces (ventricles) and raising pressure inside the skull. In babies, this can cause a rapidly enlarging head, a bulging soft spot, vomiting, sleepiness, and downward-deviated eyes, among other signs.
Why it occurs with encephalocele
Encephaloceles — especially occipital ones — can disturb the normal flow or reabsorption of CSF, so hydrocephalus may be present at birth or develop afterward, sometimes after the encephalocele is repaired. That's why teams monitor closely before and after surgery.
Why it matters for outlook
The presence of hydrocephalus is associated with a more guarded outlook for encephalocele. Importantly, though, treating hydrocephalus is a well-established part of care, and managing it well is a key way the team protects the brain.
How it's treated
The most common treatment is a shunt — a thin tube that drains excess CSF from the brain to another part of the body (often the abdomen), where it's reabsorbed. This is called a ventriculoperitoneal (VP) shunt. An alternative in some children is an endoscopic third ventriculostomy (ETV), which creates a new internal drainage pathway. Your neurosurgeon will recommend the best option.
Timing with encephalocele surgery
Sometimes hydrocephalus is treated before or at the same time as the encephalocele repair; sometimes it appears afterward and is treated then. Untreated hydrocephalus can also stress the encephalocele repair, which is another reason close monitoring matters.
Sources
- StatPearls (NCBI Bookshelf) — Encephalocele (hydrocephalus)
- Cleveland Clinic — Encephalocele / Hydrocephalus
- CHOP — Encephalocele
- Child's Nervous System / peer-reviewed literature — hydrocephalus and outcome