Hydrocephalus is an abnormal accumulation of cerebrospinal fluid (CSF) within cavities called ventricles inside the brain. It occurs when there is an imbalance between the amount of CSF that is produced and the rate at which it is absorbed.
As the CSF builds up, it causes the ventricles to enlarge and the pressure inside the head to increase. Untreated hydrocephalus may result in death or significant neurological and cognitive impairment.
The historic way to treat hydrocephalus is with a shunt. It goes from the ventricle of the brain to the abdominal cavity or another cavity that can absorb CSF. This technology has come since the late 1950s with little progress since that time. Although it works well, it creates a dependence of this implanted device. This device has the highest failure rate from all medically implanted devices often requiring multiple surgeries.
A re-emerging technique combines a procedure developed in the late 1990s, an endoscopic third ventriculostomy, using a very small camera in a minimally invasive manner to make a hole at the floor of the brain to allow CSF to escape, with a new technique called choroid plexus cauterization, which reduces the tissue that creates CSF. This increases the success rate, meaning no further operations required, in about 50-60% of children who have never been treated before for hydrocephalus. Our success rates for hydrocephalus surgery is on par with the top pediatric hospitals across the United States.
Here at UCLA, we are one of the few centers that have special expertise and experience treating children with this new re-emerging technique. Not all children will be good candidates for an ETV and CPC. In those children, we still have the option of treating hydrocephalus with traditional shunt surgery and have available to us the array of the latest shunt technology.
Modern and Comprehensive Management of Management of Pediatric Hydrocephalus – Aria Fallah
