Hydrocephalus Management

Hydrocephalus is a condition in which excessive cerebrospinal fluid (CSF) accumulates in the ventricles of the brain, either through overproduction of CSF, an obstruction of the flow of CSF, or failure of the body to reabsorb CSF. This buildup increases pressure on the brain, which can cause frequent headaches, motor problems, memory loss, nausea, and urinary incontinence in adults.

When not present at birth or in childhood, hydrocephalus is most commonly acquired by adults over the age of 40. Acquired hydrocephalus can have many causes, including tumors, bacterial infections such as meningitis, hemorrhage or bleeding within the brain, and traumatic injury. At times, no definitive cause is apparent.

At UBNS, Drs. Walter Grand and Jody Leonardo specialize in the diagnosis and minimally invasive treatment of hydrocephalus. They also evaluate and monitor patients with previously treated hydrocephalus to determine if problematic shunts need to be replaced or removed altogether.

Shunts

The treatment of hydrocephalus generally focuses on remedying CSF overproduction or diverting CSF buildup away from the head by way of surgically placed tubes called shunts. Though effective, shunts require invasive open surgery with incisions in both the scalp and abdomen, and shunts are occasionally associated with serious complications, including infection, over-drainage, and shunt malfunction. For these reasons, hydrocephalus patients with shunts need to be regularly seen by a specialized physician to ensure proper shunt function.

Minimally Invasive Approach

A modern minimally invasive alternative to the shunt is the endoscopic third ventriculostomy (ETV). In this procedure, an endoscope is introduced through a small hole in the skull into the third ventricle of the brain where a perforation is made in a membrane to restore normal flow of CSF. The entire procedure is performed using video guidance, and no device or hardware is implanted in the body. Therefore, if successful, no revisions or replacements are necessary, and subsequent hospitalizations are markedly reduced. Though not all hydrocephalus patients are eligible, approximately 70-80% of properly selected patients are successfully treated by ETV.

For more information on the UBNS hydrocephalus clinic, call (716) 887-5200.

back to top