Treatment
There is no known way to prevent or cure hydrocephalus. If obstruction
is found on CT scan due to a tumor or cyst, it can be excised
by a neurosurgeon to re-establish the CSF pathway. In other situations
the most effective treatment is insertion of a shunt (at a known
pressure gradient). The shunt is a hollow silicone tube, placed
into the ventricular system, diverting the CSF flow to the peritoneal
cavity of the abdomen (VP shunt). If abdominal cavity is unable
to absorb the fluid due to some disease viz. TB or cyst, the shunt
can be placed via the jugular vein to reach the right atrium of
heart (VA shunt). Shunts can also be placed in the pleural (chest)
cavity.
In
communicating hydrocephalus (malabsorption of CSF but no blockage)
a Lumboperitoneal (LP) shunt can also be performed on order children
where the tube goes from the spinal cavity to abdomen.
The
operation to insert a shunt is performed with extremely strict
sterile precautions by either a pediatric surgeon or neurosurgeon.
This procedure takes about 1-2 hours.
After operation
The child will be observed for a short time, in the recovery area
and then transferred to the bed. He/she will be allowed fluids
after 12 hours and normal food after 24 hours.
Usually
after 5-7 days the child can go home. Sometimes, a CT scan may
be repeated to confirm the success of the treatment.
Endoscopic treatment
In selected cases as judged by the neurosurgeon, endoscopic procedures
may be used to create alternative CSF pathways(s) within the brain
(e.g. third ventriculostomy, aqueductal stenting) and shunt may
not be necessary.
These
techniques are developing and may find wider applications in the
future.
Last
updated on 09-10-2001
