Hydrocephalus surgery
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Hydrocephalus Microchapters |
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Hydrocephalus surgery On the Web |
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American Roentgen Ray Society Images of Hydrocephalus surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor-In-Chief: Syed Ahsan Hussain, M.D.[2] Cafer Zorkun M.D., PhD.,Kalsang Dolma, M.B.B.S.[3]
Overview
Surgery is the preferred treatment of hydrocephalus. Various shunt surgeries are done to bypass the cerebrospinal fluid flow obstruction and drain the excess fluid into other body cavities.
Surgery
Hydrocephalus treatment is surgical.
For a detailed approach on performing cerebral shunt watch the video below: {{#ev:youtube|bHD8zYImKqA}}
The mainstay of treatment for hydrocephalus is medical therapy. Surgery is usually reserved for patients with either increased ICP, stroke and subarachnoid hemorrhage.
The feasibility of surgery depends on the stage of hydrocephalus at diagnosis.
- The surgical methods of hydrocephalus are given below:
- The decompressive crainectomy with shunting is the main surgical method use in hydrocephalus.
- Shunting:It involves the placement of a ventricular catheter.
- Shunt is the tube placed in cerebral ventricles to bypass the flow of malfunctioning arachnoidal granulations.
- Shunt, drains out the excess fluid into other body cavities, which is resorbed from there.
- Types of shunts done are
- ventriculo-peritoneal shunt (most common): Tube is placed in peritoneal cavity.
- Long peritoneal catheter can be used so as to obviate the need to change the catheter as the child grows
- ventriculo-atrial shunt: Tube is placed in right atrium.
- ventriculo-pleural shunt: Tube is placed in pleural cavity.
- Lumboperitoneal shunt: shunt system can also be placed in the lumbar space of the spine and have the CSF redirected to the peritoneal cavity
- Endoscopic third ventriculostomy:
- The procedure of endoscopic ventriculostomy is given below:
- A surgically created opening in the floor of the third ventricle allows the CSF to flow directly to the basal cisterns.
- It removes the obstruction in aqueductal stenosis.
Shunt complications
Possible complications include
- Shunt malfunction
- Shunt failure
- Shunt infection
- When CSF drains more rapidly than it is produced by the choroid plexus it causes following symptoms:
- Severe headaches
- Irritability
- Light sensitivity
- Sound sensitivity
- Nausea
- Vomiting
- Dizziness
- Vertigo
- Migraines
- Seizures
- Personality changes
- Weakness in the arms or legs
- Excessive head growth (seen infants, children under age 2)
- Double vision.
- Resistance to traditional analgesic pharmacological therapy may also be sign of shunt overdrainage or failure.
- Diagnosis of the particular complication usually depends on when the symptoms appear.