Treating Normal Pressure Hydrocephalus
When normal pressure hydrocephalus is properly identified, treatment is successful more than 80 percent of the time.
Treating normal pressure hydrocephalus
Treating normal pressure hydrocephalus consists of inserting a small tube (shunt) into your brain. The shunt allows the fluid to drain into your abdomen, where it is absorbed. A valve is attached to the shunt to control how much fluid drains. The shunt:
- Controls how much fluid is in your brain
- Helps prevent fluid from building up
- Reduces pressure on your brain
- Improves your symptoms
What is a shunt and how does it work?
The shunt is a system of two tiny tubes (also called catheters) that are connected by a valve. One tube runs from the ventricles in your brain to the valve. The other runs from the valve to your abdomen. This system allows extra spinal fluid from your brain to drain into your abdomen where it can be absorbed by your body. The valve controls how much fluid drains and ensures the right amount is still available to protect and cleans your brain. Sometimes a second tube may be used to drain the extra fluid into the blood vessels near the heart or the space around the lungs.
What happens during the surgery to implant the shunt?
Before surgery, your neurosurgeon will talk with you about the procedure to be certain you understand everything that will take place. Your anesthesiologist will also talk with you.
The shunt implant surgery takes place in an operating room at the hospital. The procedure takes about 30 minutes. A small section of hair on your head will be shaved to ensure the area is sterile. Your head will be thoroughly washed with special soap. You will be completely asleep for the procedure.
When you are asleep, the neurosurgeon will make a small incision in your scalp. Then he or she will make a small hole in your skull and in the protective covering of the brain in order to place the tube in the ventricle. The tube will be tunneled under your skin. The surgeon will make an additional incision (usually above or behind your ear) to place the valve. The tubing will be tunneled to the abdomen below the ribs. It will be inserted either through a small incision there, or it will be inserted with the assistance of a general surgeon using a laparoscope and two tiny incisions.
After placing the tube and valve, the doctor will cover the incisions with sterile bandages.
After the procedure, we will move you to the recovery room. Once you are awake, we will move you to a room in the hospital. You will stay overnight in the hospital so we can monitor your recovery. Most patients go home after one or two days.
Will the shunt be visible after surgery?
You will notice a small lump behind your hairline and above your ear where the valve is located. Your hair will grow back in that area, so it will not be noticeable to most people.
Recovering after surgery
You will be able to resume your daily activities after you leave the hospital. Although the valve is beneath the skin on your head and protected, you should be careful not to bump it.
During the first few months we will schedule you for several clinic visits. We will check the valve and ensure you are recovering well. We will also check to make sure the spinal fluid is flowing correctly. We are able to adjust the valve to make the flow just right.
After the first few months, you will have checkups once a year.
The neurosurgeon also may prescribe physical therapy or an appointment with a rehabilitation specialist to help you work on any problems you still have with walking, standing or balancing.
Will all of my symptoms go away after surgery?
Usually, we see the greatest improvement in walking, standing and balance after inserting a shunt. It is more difficult for us to know how much improvement you will see with memory and bladder-control problems. How much you improve will depend on how serious those symptoms were by the time you had surgery.
A note about magnets/future MRIs
A magnet, like the magnets in an MRI, can affect the valve. If you need an MRI in the future, let the doctor know about your valve.
Adult Hydrocephalus Program751 N.E. Blakely Dr.
Issaquah, WA 98029
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Affiliated clinic: Cranial, Spine and Joint Clinic at Providence Everett