SLIDE 1
What is cerebrospinal fluid?
Your brain and spinal cord have a
surrounding protective layer of cerebrospinal
fluid (CSF). CSF contains nutrients that your
brain can use. The CSF layer also supports
and cushions your brain and spinal cord from
sudden movements.
The effect is similar to putting a grape inside
a jar. If the jar is empty and you give it a good
shake, you’ll bruise or damage the grape.
That’s what would happen to your brain if
you had no CSF. But if you fill the jar with
water and then shake it, the water slows down
how fast the grape moves and cushions it,
preventing damage.
Hydrocephalus is a buildup of cerebrospinal
fluid, or CSF, in the brain.
This fluid surrounds the brain and spinal cord
to cushion and support them.
When there is a build-up of CSF, this can put
pressure on the brain, which can lead to
problems. Cerebral spinal fluid is made
constantly by a tissue within the ventricles of
the brain. The CSF circulates through the
ventricles, down around the spinal cord, and
over the
surface of the brain.
Once on the surface of the brain, CSF is
reabsorbed back into the blood stream.
The creation, circulation, and reabsorption of
CSF is a constant and steady cycle. Any time
there is a blockage, a problem with re-
absorption, or overproduction of CSF, the
fluid builds up and hydrocephalus occurs as a
result.
SLIDES 2
Communicating hydrocephalus occurs
when the flow of CSF is blocked after it exits
the ventricles. The word “communicating”
refers to the fact that CSF can still flow
between the ventricles, which remain open.
Non-communicating hydrocephalus - also
called obstructive hydrocephalus - occurs
when the flow of CSF is blocked along one or
more of the narrow passages connecting the
ventricles.
The most common causes are post hemorrhagic
or post-inflammatory changes. Subarachnoid
hemorrhage accounts for one-third of these
cases by blocking CSF absorption at the
arachnoid granulations. Meningitis, especially
bacterial, can be complicated with
hydrocephalus.
SLIDES 3
According to WHO (2022) Congenital
Hydrocephalus occurs in two out of every
1,000 births in the United States. It is not
known how many people develop it after
birth. The overall global prevalence of
hydrocephalus is approximately 85 per
100,000 individuals with a significant
difference between different age groups: 88
per 100,000 for the pediatric population and
11 per 100,000 in adults. The prevalence in
the elderly population is much higher,
somewhere around 175 per 100,000, and
more than 400 per 100,000 for those more
than 80 years old due to the high incidence of
normal pressure hydrocephalus later in life.
SLIDES 4 Furthermore, most of the newborns born with
hydrocephalus will have a normal lifespan,
According to the study of Narayana (2019)
and approximately 40 to 50 percent will have
Hydrocephalus cases are affecting the
normal intelligence. Seizure disorders have
Philippines every day. The incidence of
been diagnosed in about 20 percent of
congenital hydrocephalus is 3 per 1, 000 live
children with hydrocephalus. The mortality
births; the incidence of acquired
rate for infants is approximately 5 percent. 
hydrocephalus is not known exactly due to
the variety of disorders that may cause it.
Incidence of acquired hydrocephalus is
SLIDES 7
unknown. Non-communicating is 60% of all
cases of hydrocephalus and in 40% of Another criterium is the response to a single
children with communicating hydrocephalus. lumbar puncture or external lumbar drain.
Incidence is equal in males and females. Improvement of symptoms after a single
lumbar puncture with 40-50 ml of CSF
drained or after the lumbar drain is
SLIDES 5 considered a positive predictive value for
shunt success. Persistent ventricular activity
A study conducted by NIH (2020) stated that
48 to 72 hours after isotopic cisternography
Hydrocephalus cases are affecting the
gives more than a 75% chance of relieving
Philippines every day. Almost 6 in 10
the symptoms with shunt placement.
hydrocephalus cases in the Philippines were
either post-infectious, congenital, or tumor
related. VPS insertion was the most common
procedure for CSF diversion in the Philippine
center (92%). 

SLIDES 6
Devia et al. (2022) points out that
Hydrocephalus is a chronic condition. It can
be controlled, but usually not cured. With
appropriate early treatment, however, many
people with hydrocephalus lead normal lives
with few limitations. Hydrocephalus can
occur at any age but is most common in
infants and adults age 60 and older. Survival
in untreated hydrocephalus is poor.