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Whether or not comprehension and/or speech are affected depends on the severity of the hydrocephaly and the extent of brain tissue damage. When the higher intellectual functions are affected (comprehension), it's due to tissue damage to that area of the brain that is responsible for that function. Same for adverse effects to Broca's area. In some cases, it may be auditory function that's been affected. If you understand what hydrocephalus is to begin with then it's almost self-explanatory.

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