Hydrocephalus Surgeries
Hydrocephalus can be corrected through surgical interventions performed by neurosurgery specialists. The type of surgical intervention to be selected will vary depending on the underlying cause of hydrocephalus.
If there is an obstruction causing disruption of the circulation of cerebrospinal fluid, surgical treatment may be performed for the obstruction causing it (tumor, cyst, etc.). If the obstruction cannot be removed, the intracranial circulation pathways of the cerebrospinal fluid may be altered through surgical procedures.
In most patients, since it is not possible to restore the circulation of cerebrospinal fluid to its previous state, the fluid must be diverted from the brain to another body cavity. For this transfer, a thin, long, elastic silicone tube called a "shunt" is used. In order for the system to function in one direction and at a controlled rate, there is a part of the system called a "pump" under the scalp. Excess cerebrospinal fluid is carried to another part of the body through this thin tube. Thus, the increase in pressure inside the brain is prevented. However, since fluid is continuously produced in the brain, this system must work continuously. Because the shunt is under the skin, it can only be noticed from the outside in babies. In children and adults, the tube under the skin can be felt during manual examination.
The shunt is placed surgically under general anesthesia. A small hole is made in the skull, and the tip of the shunt is placed into the chamber inside the brain where the cerebrospinal fluid is located. Then, a tunnel is created under the skin of the head, neck, and abdomen, and the other end of the shunt is directed into the heart or abdominal cavity, where this fluid can be easily absorbed.
After surgery, the patient is observed in the hospital for a period of time. Generally, the patient’s complaints improve after a while. However, if permanent damage has occurred in the brain tissue, some functions may not recover. The most important reason why functions such as vision and intelligence may not improve is delayed treatment. The length of the patient’s hospital stay varies depending on the recovery status. These patients need to be followed for a long time in terms of monitoring whether the shunt is functioning properly. A significant number of patients treated for hydrocephalus can continue their normal lives. The shunt may need to be replaced in cases of malfunction or infection.
Skull X-rays and brain tomography do not damage the shunt system. For magnetic resonance imaging, the shunt type must be suitable. If there is a shunt whose pressure setting can be adjusted externally and that is affected by magnetic fields, the doctor should be consulted before magnetic resonance imaging is performed.
No type of shunt can be made to function by pressing on it externally by hand. The doctor performs the manual examination of the shunt. Pressing the pump excessively will cause it to malfunction.
Especially during infancy, it is not appropriate to lay the baby on the side where the shunt is located.
The brain’s dependence on the shunt system may continue for many years. In most patients, the need for a shunt continues for life. If there is no problem in most patients, removal of the shunt is not recommended.
Points to Consider
Regular and frequent check-ups should be attended in order to prevent shunt complications. If there is;
- redness and tenderness at the surgical site and along the shunt line,
- restlessness, nausea, vomiting in the patient,
- headache, double vision, fever, abdominal pain, seizures,
- recurrence of preoperative complaints
the doctor must definitely be consulted. If problems are not noticed early and corrected, serious outcomes that may even lead to death can occur. Shunt-related problems may develop very quickly, sometimes within hours. In case of any suspicion, it is important to contact the nearest neurosurgery center to where you live and/or the doctor who performed the surgery.
