Hydrocephalus Treatment

Hydrocephalus, simply put, means water on the brain. More precisely, hydrocephalus describes a condition in which there is an excessive amount of cerebrospinal fluid(CSF) in and around the brain. This increased amount of cerebrospinal fluid usually also causes increased pressure in the skull. This situation can cause headaches, nausea, and a lowered level of consciousness in severe cases. Hydrocephalus treatment, therefore, is aimed at reducing the volume of cerebrospinal fluid in the skull.

 

Cerebrospinal fluid is like a shock absorber, of sorts. It is produced deep within the brain and released into ventricles. Cerebrospinal fluid circulates to the outside of the brain and down the spinal cord. It is this fluid, in fact, that is removed in a spinal tap (lumbar puncture). Hydrocephalus results either from an overproduction of cerebrospinal fluid or from an ineffective removal of CSF from the skull. If the small areas between brain ventricles become compressed, for example, CSF cannot escape from the brain. This leads to a back up of CSF and increased pressure within the skull.

 

 

There are several surgeries that can be used in hydrocephalus treatment. Traditionally the most commonly performed surgical hydrocephalus treatment has been the ventriculoperitoneal shunt. In this procedure, one end of a tube is placed in the brain ventricle and the other is placed in the abdominal space (outside of the stomach and intestines). The tube is covered by skin for its entire course from brain to abdomen. As cerebrospinal fluid is produced in the brain, much of it drains into the abdominal cavity and is absorbed by the body.

 

Even though ventriculoperitoneal shunt is the most commonly performed surgical hydrocephalus treatment, it is associated with a number of side effects and complications. Since there is a tube that goes from belly into brain, it is often a source of infection. The bacteria and other microorganisms can use the shunt tube to enter the brain and cause serious brain infections. If this occurs, the tube must be removed and replaced.

 

Another hydrocephalus treatment that is gaining in popularity among surgeons is called third ventriculostomy. In this procedure, a new outlet is created for the third ventricle of the brain. Essentially a new tunnel is created by the neurosurgeon so that the cerebrospinal fluid can escape into the spinal cord space. This form of hydrocephalus treatment is associated with a much lower risk of infection than ventriculoperitoneal shunting.

 

If overproduction of CSF is the problem, rather than a blockage of drainage, a hydrocephalus treatment known as a lumboperitoneal shunt can be performed. This surgery is like the ventriculoperitoneal shunt except that instead of a tube connecting the brain to the abdominal space, the tube is placed in the spinal cord, low in the back, so that excess fluid can be drained in that way.

 

If you have had or are planning to have surgical hydrocephalus treatment, it is important to notify any future physicians that care for you about this surgery, even if they are not directly caring for the hydrocephalus. In many cases, prior hydrocephalus treatment may mean that you are no longer able to have an MRI if the shunt remains in your body.