This procedure is known as an endoscopic third ventriculostomy. In many patients, this is a durable treatment and forgoes the need for a ventriculoperitoneal shunt.
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After discussing your medical history and symptoms, your doctor will order a scan of your brain. These imaging techniques allow your doctor to examine the ventricles in the brain to see if they are larger than normal. One of the following brain imaging techniques will be used:. If the patient is an adult, your doctor will perform other tests to diagnose hydrocephalus. These may include:. Unfortunately, there is no cure for hydrocephalus.
The only treatment that is currently available is brain surgery. There are two forms of surgical management for hydrocephalus, these include:. This is the most common form of treatment for hydrocephalus.
The procedure involves the implantation of a device called a shunt. The shunt contains a small valve which maintains the correct pressure within the ventricular system.
The tube gathers CSF in the brain and transports it to another area of the body where it can easily be reabsorbed. The shunt exits the brain via a small hole in the skull and connects to an outflow catheter which runs under the skin to the area of the body where it will be deposited drainage site.
Prior to the surgery, you will be given a general anesthetic. A small area behind your ear will be shaved in preparation for inserting the shunt. After making a small incision behind your ear, the surgeon will drill a small hole into your skull.
A catheter will be inserted into the brain via this hole. A second catheter runs from the hole, behind your ear, to your abdomen. This tube runs under the skin and allows the unwanted CSF to drain. As the CSF pressure in your skull increases, the shunt will automatically trigger and begin draining fluid. Recovery takes three or four days. Typically, patients return home a week after this type of surgery. This procedure is commonly used to treat obstructive hydrocephalus and aqueductal stenosis.
The main advantages ETV has over a ventriculoperitoneal shunt is that there is no need to implant anything in the brain, the surgery is less invasive, and there is a lower risk of complications following the procedure. ETV also has a quicker recovery time than the shunt surgery.
CSF flows from the third ventricle to the fourth ventricle through a tube called the cerebral aqueduct. When this passageway becomes constrained or blocked due to an infection, tumors, chiari malformation, or abnormal brain development this is called Aqueductal Stenosis.
The burr hole in the third ventricle allows excessive CSF fluid to drain naturally into the subarachnoid cisterns specifically the chiasmatic and interpeduncular cisterns bypassing any obstruction in the cerebral aqueduct. Now within the subarachnoid cisterns, CSF is properly reabsorbed into the bloodstream decreasing the buildup of CSF and pressure on the brain. This procedure is suitable for child and adult patients who have been diagnosed with obstructive or non-communicating hydrocephalus.
Prior to the procedure, you will be given a general anesthetic. The surgeon will make a small incision in the scalp and insert a small endoscope a flexible tube with a light and a camera attached.
The cerebral aqueduct can be found in the midbrain. The midbrain. The brainstem is an area in the. The cerebral aqueduct is the only major part of the ventricle system. The choroid plexus is a. The cerebral aqueduct can become blocked.
Hydrocephalus may be also be classified as congenital or acquired. Congenital hydrocephalus is present at birth and may be caused by either events or influences that occur during fetal development, or genetic abnormalities. In rare cases, congenital hydrocephalus may not cause symptoms in childhood but only manifest in adulthood and may be associated with aqueductal stenosis. Acquired hydrocephalus develops at the time of birth or at some point afterward.
This type of hydrocephalus can affect individuals of all ages and may be caused by injury or disease. Hydrocephalus ex-vacuo is another form of hydrocephalus that does not fit exactly into the categories mentioned above and primarily affects adults. Hydrocephalus ex-vacuo occurs when stroke , degenerative diseases like Alzheimer's disease or other dementias or traumatic injury cause damage to the brain.
In these cases, brain tissue may actually shrink. These symptoms may not occur all at the same time, and sometimes only one or two symptoms are present. The triad of symptoms is often associated with the aging process and a majority of the NPH population is older than 60 years. Their involvement is helpful not only in interpreting test results and selecting likely candidates for shunting, but also in discussing the actual surgery and follow-up care as well as expectations and risks of surgery.
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