A child can have both spina bifida and hydrocephalus. Approximately two third of children with spina bifida in Uganda also develop progressive hydrocephalus. Ventricles or cavities of the brain in all persons produce cerebral-spinal fluids and it is absorbed in the brain and spinal cord.

However, hydrocephalus develops if there is no balance between the cerebral-spinal fluids produced and that that which is absorbed. This can also occur with people without spina bifida. If the natural circulation of CSF is obstructed, fluid accumulates in the brain and hydrocephalus results.

The excess fluid presses on the brain causing damage to the surrounding tissue. In babies and infants where the skull is still soft, the head enlarges. This obstruction of the normal CSF pathways can be caused by abnormal brain anatomy as is the case with spina bifida. It can also be the result of meningitis (cerebral malaria), trauma or intracranial bleeding which occurs more frequently following premature birth. Hydrocephalus, also called Water on the Brain, is a condition in which there is an abnormal build up of fluids in the cavities of the brain. The buildup is often caused by an obstruction which prevents proper fluid drainage.

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