Review of the Treatment & Management of Hydrocephalus

Jacqueline Groat, PharmD Candidate; Joshua J. Neumiller, PharmD, CDE, CGP, FASCP


US Pharmacist. 2013;38(3):HS-8-HS-11. 

In This Article


Because hydrocephalus has many different causes, it is difficult to classify specific varieties. As a result, many different classification systems have been developed. The most common way to classify hydrocephalus is to determine whether a case is 1) congenital or acquired or 2) obstructive or communicating. Congenital hydrocephalus is caused by a birth defect or genetic disorder; acquired hydrocephalus has other causes, such as a hemorrhage, infection, or tumor.[1] Obstructive hydrocephalus is caused by an obstruction of CSF drainage by a tumor, congenital defect, or infection.[6] Most cases of hydrocephalus are obstructive. Communicating hydrocephalus is caused by an overproduction of CSF that allows insufficient drainage time, or occurs when CSF is not absorbed at a normal rate. Examples include cranial hemorrhage and meningitis.[6]

Other classifications have been developed that specify the type of hydrocephalus, such as normal pressure hydrocephalus (NPH). A relatively new classification system is the multicategorical hydrocephalus classification (McHC), which is complicated and involves eight different categorical sections, including cause, pathophysiology, and occurrence of shunt placement.[7] McHC is little known and seldom used, but it does provide a more accurate description of each patient's case as it progresses. Regardless of the cause and subsequent classification, hydrocephalus patients present with similar symptoms (although these differ with age) and have the same limited number of treatment options.