Hydrocephalus is a very serious medical condition in which the ventricle cavities in the brain are essentially flooded by excessive buildup of cerebrospinal fluid (CSF). External hydrocephalus occurs in both children and adults, but it is frequently seen in newborn infants as a result of head trauma during childbirth.
The term hydrocephalus literally translates into "water in the brain" (the Greek root word "hydro" means water and "cephalus" means the head). Hydrocephalus occurs when the ventricles of the brain become flooded with cerebrospinal fluid (CSF).
CSF is a complex fluid that is continuously produced inside the ventricles of the brain. Once produced in the ventricles, the CSF is supposed to circulate out the brain and spine and then get absorbed into the bloodstream.
Hydrocephalus occurs when something blocks the normal flow and absorption of CSF into the bloodstream causing a build-up of CSF inside the ventricles. The CSF eventually floods the ventricles causing internal pressure within the brain.
Hydrocephalus cab either be acquired or congenital. Congenital hydrocephalus develops before birth as a result of genetic and/or developmental flaws. This type of hydrocephalus can often be diagnosed during pregnancy. Acquired hydrocephalus occurs during childbirth or soon after as a result of head trauma, injury, disease, or some other medical issue.
Hydrocephalus is also further classified as either communicating or non-communicating based on exactly where the blockage of cerebrospinal fluid (CSF) occurs. When the flow of CSF is being blocked after leaving the brain ventricles it is considered "communicating" because the CSF can still circulate from one ventricle to another.
Non-communicating hydrocephalus is present when the flow of CSF is actually blocked between the brain ventricles.
Acquired hydrocephalus occurs when the normal flow and absorption of CSF is blocked as the result of some external event or condition. Trauma or injury to a baby's head during labor and delivery is one of the most common events that cause hydrocephalus. Excessive force or pressure to the baby's head during childbirth can damage delicate brain tissue and rupture blood vessels in the brain.
The resulting inflammation or excessive blood cells within the brain can easily block the pathways and obstruct the flow and absorption of CSF. With normal circulation restricted in this way, CSF eventually builds up within the ventricles and develops into hydrocephalus.
There is no simple "cure" for hydrocephalus once it develops and no method of prevention. Currently, the only treatment option for hydrocephalus is surgery. Surgical intervention aims at clearing the blockage and restoring normal outflow of CSF. Performing brain surgery on an infant is very difficult and risky and does not always result in long-term success.
Hydrocephalus is a very serious and potentially life-threatening condition. The buildup of the CSF within the brain can cause pressure and prevent normal brain development. Moreover, hydrocephalus can be a progressive condition that gets worse over time. If not diagnosed and treated the internal pressure in the brain from hydrocephalus can cause death.
Can Hydrocephalus Be Genetic?
The science is mixed on whether there is a link between genetic factors and hydrocephalus.
External hydrocephalus after birth from head trauma during labor is a common medical malpractice lawsuit. In many of these birth injury lawsuits, head injuries during childbirth are the result of medical negligence by the doctors and staff in the labor and delivery room. When the baby becomes stuck in the birth canal, doctors will frequently use devices such as forceps or a vacuum extractor to facilitate a vaginal delivery. The suction cup in the vacuum and the forceps can cause external hydrocephalus.
Effective use of these devices requires a large degree of skill and care to avoid an external hydrocephalus birth trauma. Many doctors simply do not have the necessary training and skills or they make costly mistakes that result in head trauma. Head injury can also occur when doctors fail to recognize fetal distress and continue with vaginal delivery instead of a C-section.
- A.M., Pro Ami v. Winthrop University Hospital (New York 2019) $500,000: A premature newborn suffered brain damage, periventricular leukomalacia, hydrocephalus, intraventricular hemorrhage, and bronchopulmonary dysplasia. He developed myoclonic seizures, spastic quadriplegia, and white matter loss. The boy was left with developmental and cognitive delays. His mother alleged negligence against the hospital. She claimed its staff provided poor prenatal and postpartum care, prescribed contraindicated medications, and failed to order appropriate tests. This case settled for $500,000.
- F.L.P., Pro Ami v. Beaver Medical Group (California 2019) $2.4 million: A newborn girl was born with spina bifida, hydrocephalus, and myelomeningocele. She suffered paraplegia and bladder and bowel incontinence. The girl’s parents alleged negligence against the hospital. They claimed its staff failed to follow up on the prenatal ultrasound, order blood screening tests, and warn them that their child might suffer from spina bifida and other genetic diseases. This case settled for $2.4 million.
- Muhammad v. Northwestern Memorial Hospital (Illinois 2018) $18.5 million: A woman was prescribed Depakote. She suspected she was pregnant. The pregnancy test was negative. The woman continued taking Depakote for four months. She took another pregnancy test. It was positive. The woman stopped taking Depakote. Her son was born with several brain injuries hydrocephalus, spina bifida, and other brain injuries. The woman and her husband alleged negligence against the hospital. They claimed its staff improperly prescribed Depakote, failed to discontinue it, and timely perform a pregnancy test. The couple received an $18,500,000 jury verdict.
- Sanchez v. The Jamaica Hospital (New York 2018) $78.7 million: A baby girl was born at 29 weeks. Two days later, she sustained an intraventricular hemorrhage and hydrocephalus. The girl experienced total blindness and seizures. She was hospitalized for two weeks. The girl was ultimately diagnosed with cerebral palsy, seizure disorder, and developmental and cognitive impairments. She required physical therapy and seizure medications. The girl’s parents alleged negligence against the hospital. They claimed its staff failed to counsel the mother on progesterone and discharged her too soon. The jury awarded $78.7 million.
- Tate v. United States (Pennsylvania 2018) $42 million: This case is the story of an OB/GYN who inappropriately attempted a mid-forceps delivery during difficult labor. Poor skill and excessive use of force with the forceps caused external trauma to the baby’s head resulting in hydrocephalus. The hydrocephalus triggered swelling and internal brain hemorrhaging and a shunt had to be surgically implanted in the baby’s brain to alleviate the pressure. The baby subsequently underwent six surgeries on his brain and was left with severe and permanent neurologic damage that caused mental delays and significant physical disabilities. Following a bench trial in federal court, the judge awarded plaintiffs $42 million in damages.
- J.P. Pro Ami v. New York City Health and Hosp. (New York 2017) $2.7 million: The child in this case allegedly suffered hydrocephalus and other brain injuries when doctors and the hospital failed to recognize placental abruption and perform timely C-section in response. Injuries left the child with severe mental disabilities. He requires significant medical assistance on daily basis. The case settled for $2.7 million.
- Maime v. Temple Physicians (Pennsylvania 2015) $950,000: Pregnant mother went to her OBGYN at 27 weeks because of heavy bleeding. She suffered from placental previa. Internal examination of mothers with placental previa is not recommended because they are known to cause hemorrhage. Despite this, the doctor performed an internal examination which allegedly caused serious hemorrhage and led to emergency C-section delivery. The baby was born with hydrocephalus and underwent brain surgery leaving him with various alleged developmental delays and issues. Defendants disputed liability and damages but eventually settled the case for $950,000.
- Espinal v. Perez (New York 2006) $1.2 million: In this case, the child was apparently born with hydrocephalus and his pediatrician negligently failed to diagnose the condition for almost 3 years. By 5 months old the child had a head size that was "off the charts" for his age. His head was so enlarged that his father's hat was too small to fit on his head. He also had developmental delays and persistent vomiting. Despite concerns from the parents, however, the child's pediatricians insisted there was nothing wrong and that he just had an abnormally large head for his age. No testing was ever performed on his head. When he was 2 he went to a hospital for an unrelated condition and concern over his head size prompted one of the interns to write a letter of concern to the child's pediatricians - which they ignored. Eventually, the parents took him for testing and he was diagnosed with hydrocephalus and underwent brain surgery. The parents sued the pediatricians claiming that the 3-year delay in diagnosis of the condition resulted in permanent brain damage. The defendants argued that the child's brain damage was caused by another condition and not by their failure to diagnose his external hydrocephalus. The case settled days before trial for $1.2 million.
If you have a child with hydrocephalus it may have been caused by medical negligence during childbirth. The birth injury attorneys at Miller & Zois can help investigate whether you have a malpractice claim and deliver results if you do. Call our Maryland birth injury malpractice lawyers at 800-553-8082 today or get a free online consultation.