Often the etiology of hydrocephalus is due to blockage of the cerebrospinal fluid exiting the ventricles.
The most common site of this blockage is at the cerebral aqueduct, called aqueductal stenosis. Though this occurs more commonly in children, it can present in adulthood.
Other locations of blockage can occur at the third or fourth ventricles. Patients can have progressive symptoms of headaches, memory difficulties, blurred vision, double vision and/or imbalance. Most commonly, people are born with such blockages, though patients can acquire these from infection or trauma.
For obstructive hydrocephalus, endoscopic surgery is performed to create an internal “bypass,” allowing the fluid to escape the inside of the brain and equalize the pressures. This procedure is known as an endoscopic third ventriculostomy. In many patients, this is a durable treatment and forgoes the need for a ventriculoperitoneal shunt.