Treatments
While there is currently no known way to prevent or cure hydrocephalus, modern treatments allow patients to embrace a standard lifestyle and engage in regular activities.
The most common and effective treatment for hydrocephalus involves a surgical procedure. The choice of treatment depends on the type and severity of hydrocephalus and should be made in consultation with a neurosurgeon or other healthcare professional with expertise in the treatment of hydrocephalus.
Depending on the severity and underlying cause of the hydrocephalus, there are two main surgical options:
- Brain shunt surgery
- Endoscopic third ventriculostomy (ETV) surgery
Treatment Options for Hydrocephalus
Shunt Surgery
A surgical procedure that involves placing a shunt system to relieve pressure on the brain caused by fluid accumulation.
Endoscopic Third Ventriculostomy
A minimally invasive procedure that creates a pathway for cerebrospinal fluid to flow, bypassing obstructions.
Medication Management
Utilising medications to manage symptoms and reduce cerebrospinal fluid production in certain cases.
Shunt Surgery
Brain shunt surgery is a medical procedure that involves inserting a valve and thin, flexible tube called a shunt into the brain to help drain excess cerebrospinal fluid (CSF) that has built up.
Shunts have been used to treat hydrocephalus since the 1950s. Shunting is a process of redirecting or rerouting something from its original path or destination to another location or pathway. In people with hydrocephalus, the shunt is typically placed in the brain ventricle, a fluid-filled space inside the brain, and it is then tunneled under the skin to another part of the body, usually the abdomen or the heart, where the excess fluid can be safely absorbed or eliminated.
The shunt has a one-way valve that regulates the flow of CSF and prevents it from flowing too quickly or too slowly. As the pressure of CSF increases inside the brain, the one-way valve opens and the excess fluid drains.
This surgery is usually performed under general anaesthesia, and patients may need to stay in the hospital for a few days after the procedure to monitor their condition and ensure proper healing.
Overall, while shunt surgery is generally considered safe and effective, it does carry some risks of complications.
Ventriculo-peritoneal (VP) shunt
This is the most common treatment, which shifts fluid from the brain into the peritoneal cavity (a fluid-filled gap between the walls of the abdomen and the organs in the abdomen).
Ventriculo-pleural (VPL) shunt
Shifts fluid from the brain into the pleural cavity (space between the two pleura of the lungs).
Ventriculo-atrial (VA) shunt or Vascular shunt
Shifts fluid from the brain to the right atrium of the heart.
Lumbar-peritoneal (LP) shunt
This type of shunt moves cerebrospinal fluid (CSF) from the lower back area to the abdominal cavity. This treatment is a good option for patients who cannot use standard shunt systems.
Ventriculo-gallbladder (VGB) shunt
This shunt shifts fluid from the brain to the gallbladder. It is not common but may be used in cases when treatment with other shunt locations is not possible. This might be due to infection, previous shunt failure, or if there is a congenital abnormality in the more common shunt locations.
Subdural-peritoneal shunt (SDP)
This shunt shifts fluid from subdural space to the peritoneal cavity.
These shunts have the following additional features:
- Fixed pressure shunt (most common) – regulates the flow-rate of the fluid based on a predetermined pressure setting; it is used for specific situations in which fluid output needs to be regulated.
- Programmable shunt – adjusts how much fluid is drained by a patient’s VP shunt, even after that shunt has been placed, because it is externally adjustable by a magnetic device.
Endoscopic Third Ventriculostomy
Endoscopic Third Ventriculostomy (ETV) is a less invasive surgical procedure than shunt placement. ETV is usually only done in patients with certain types of hydrocephalus and is not suitable for all individuals.
ETV is a minimally invasive treatment option for hydrocephalus, without involving a shunt. It is only relevant for individuals where their condition follows certain criteria.
ETV uses a tiny camera called a neuro-endoscope and tiny surgical instruments to make an opening in the floor of the brain’s third ventricle, traditionally a difficult area to reach via surgery. This fibre optic technology allows the neurosurgeon to view the surface of the ventricle. This opening allows CSF to flow out of the ventricles and into the normal pathways of the brain, flowing freely through the ventricular system, reducing the pressure within the brain.
When this procedure is successful, neither a shunt nor further treatment is usually required.
The procedure is minimally invasive and has a lower risk of complications and a shorter recovery time than shunt surgery but is only suitable for particular types of hydrocephalus that meet certain criteria.
Medication Management
In some cases, medications such as diuretics or corticosteroids may be used to reduce the production of CSF or decrease inflammation within the brain. However, medication alone is rarely effective in treating hydrocephalus and is usually used in conjunction with other treatment options.
Common Questions About Hydrocephalus Treatment
Explore answers to some of the most frequently asked questions about treatment options for Hydrocephalus, helping you make informed decisions.
What are the treatment options for Hydrocephalus?
How does a shunt system work?
What is endoscopic third ventriculostomy (ETV)?
Are there risks associated with Hydrocephalus treatments?
How do I know if treatment is necessary?
Can Hydrocephalus be cured?
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