Current Treatments for Hydrocephalus

Hydrocephalus

Community Pakistan

Hydrocephalus does not have a cure. The only way to treat Hydrocephalus is through brain surgery. A patient with hydrocephalus may require multiple brain surgieries in their lifetime

Shunt Systems

Shunt systems manage the flow of excess cerebrospinal fluid (CSF) in hydrocephalus patients. They consist of a catheter placed in the brain, a valve to regulate fluid flow, and another catheter that directs fluid to the abdomen for absorption. Shunts help maintain normal brain pressure, relieving symptoms and preventing complications. While durable, they may require adjustments or replacements over time.

Type of Shunt Systems

VP Shunt

VP (ventriculoperitoneal) shunts redirect excess fluid from the brain's ventricles into the peritoneal cavity, located in the abdomen, where the digestive organs reside.

VA Shunt

VA (ventriculoatrial) shunts channel fluid from the brain to the heart, with the distal catheter placed into a vein in the neck and advancing the fluid into the right atrium.

VPL Shunt

VPL (ventriculopleural) shunts divert excess fluid into the pleural cavity, a space between the chest wall and lungs lined by membranes that facilitate fluid absorption.

LP Shunt

VP (ventriculoperitoneal) shunts redirect excess fluid from the brain's ventricles into the peritoneal cavity, located in the abdomen, where the digestive organs reside.

Endoscopic Third Ventriculostomy

Endoscopic Third Ventriculostomy (ETV) is a surgical procedure used to treat hydrocephalus, a condition where excess cerebrospinal fluid (CSF) builds up in the brain’s ventricles. This minimally invasive procedure creates a small opening in the third ventricle, allowing trapped CSF to bypass blockages and flow freely toward the brain’s absorption areas. ETV is often recommended for patients with obstructive (non-communicating) hydrocephalus and can serve as an alternative to the traditional shunt system.

How ETV Works

The brain has a network of ventricles that circulate cerebrospinal fluid to cushion and protect the brain and spinal cord. In cases of hydrocephalus, blockages prevent CSF from flowing properly, leading to increased pressure inside the skull. During an ETV procedure, a neurosurgeon uses an endoscope (a thin, flexible tube with a camera) to visualize the third ventricle. The surgeon then creates a small hole in its floor, allowing the fluid to drain and reduce pressure on the brain.

Types of ETV

Standard ETV

The traditional procedure involves creating an opening in the floor of the third ventricle using an endoscope and a small surgical instrument. This method is typically used for patients with obstructive hydrocephalus due to aqueductal stenosis or other blockages in the ventricles.

ETV with Choroid Plexus Cauterization

This procedure is primarily used in pediatric patients, especially infants. Along with creating an opening in the third ventricle, the surgeon also cauterizes (burns) parts of the choroid plexus, the tissue responsible for producing CSF. Reducing CSF production can further help alleviate symptoms and is often paired with ETV in young children who might otherwise require a shunt.

Revisional ETV

In some cases, the initial ETV may close or become ineffective over time. A revisional ETV can be performed to reopen or modify the original pathway for CSF drainage. This is typically required if the symptoms of hydrocephalus return.

ETV with Tumor Resection:

In cases where a brain tumor is causing the blockage, ETV can be combined with tumor resection surgery. The surgeon uses the endoscope to remove part of the tumor while also creating a pathway for fluid drainage, potentially treating both the tumor and hydrocephalus at the same time.

Hydrocephalus

Community Pakistan