Congenital Conditions Affecting the Brain and Nerves (Pediatric)

The congenital conditions affecting the brain and nerves described in this section are:

• Hydrocephalus and Post-Hemorrhagic Hydrocephalus
• Spina Bifida

What are hydrocephalus and post-hemorrhagic hydrocephalus?

Hydrocephalus is sometimes referred to as “water on the brain” though it is actually a buildup of cerebrospinal fluid causing enlargement and swelling of the brain.

Post-Hemorrhagic Hydrocephalus occurs after bleeding in the brain. Blood clots form, obstructing the flow of cerebrospinal fluid through the channels and spaces of the brain leading to buildup in the ventricles. In infants, this makes the fontanelle (soft spot) bulge and the head expand. The accumulated fluid puts pressure on the brain, forcing it against the skull. If severe, it can damage or destroy the tissues of the brain.

Hydrocephalus is diagnosed with an ultrasound of the head, performed at the baby’s bedside. In addition, a head CT scan or MRI may be ordered to evaluate the cause of the swelling.

A spinal tap may be done to remove excess fluid. A pediatric neurosurgeon may place a shunt (tube) to drain the affected portion of the brain.

What is spina bifida?

This is an abnormal development of the spinal cord. The term means "split spine." This condition occurs as the baby is developing in the womb because the neural tube, that later develops into the brain and spinal cord, does not close correctly. A portion of the spinal cord and the surrounding structures may then protrude outside the body. Depending on the affected segments of the spine, spina bifida may affect the child’s ability to walk or become toilet trained. 

Usually sensation and muscle control are affected. This condition may also impair a child’s ability to walk later on. Most infants with spina bifida can't control their urine or their stools.

Spina bifida is usually repaired soon after birth by pediatric neurosurgeons.