Treatment for hydrocephalus has advanced considerably in the last 20 years, although no known cure or prevention yet exists. Surgery is the only treatment option, and outcomes have significantly improved combined with early intervention and advanced diagnostic protocols.
This surgical treatment is the most common and successful treatment option for those with hydrocephalus. Shunting, which began in the 1950s, entails the placement of a tube (shunt) in one of the brain’s ventricles or into the space of fluid in the spine.
In order for the spinal fluid to be safely absorbed, the shunt extends to the peritoneal cavity (the area which houses the organs in the belly), the chest cavity, or the heart.
The choice of shunt depends on the type and blockage location that results in the hydrocephalus. Most patients undergo shunt placements, including the following types:
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
Although a shunt works well and saves many lives, at ANA, we recognize that complications may occur with its use. These include infection, malfunction, or shunt failure. A shunt may also disconnect, or become outgrown. Our neurosurgeons are fully equipped to help avoid and rectify any shunt problems.
Endoscopic Third Ventriculostomy (ETV)
ETV is a minimally invasive treatment option for hydrocephalus, without involving a shunt. The neurosurgeons at ANA are adept at this procedure, relevant for patients for whom the condition follows certain criteria.
ETV employs a tiny camera (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 fiber optic technology allows the neurosurgeon to view the surface of the ventricle. Trapped fluid can drain through its normal pathway. When this procedure is successful, neither a shunt nor further treatment is required.
The success rate of this non-shunting alternative depends on numerous factors, which our physicians explain in detail. This can be an option for some cases of obstructive or non-communicating hydrocephalus, and potentially other situations depending on age, cause or type of hydrocephalus, and state of the brain. You can contact our clinic to ask one of our physicians if you have any questions.