Treatment of Hydrocephalus

While there is no known cure, there are two forms of surgical treatment currently used to manage hydrocephalus. In the last 50 years, there have been incremental advancements in the diagnosis and treatment of hydrocephalus, however, long term health outcomes for individuals with hydrocephalus remain unpredictable. Often repeated neurosurgical operations are necessary to treat hydrocephalus. And it is important to recognize when treatment is failing and to stay current with doctors and developments even when things are going well. Learn more about treatment complications and what to be alert for.

Shunt Systems

The most common treatment for hydrocephalus—and the most common procedure performed by pediatric neurosurgeons in the United States—is surgical implantation of a device called a shunt. A flexible tube and valve system, a shunt drains cerebrospinal fluid from the brain to another part of the body.

Shunt Operation Statistics

  • About 40,000 shunt-related operations are performed every year in the US for hydrocephalus—that averages out to one every 13 minutes and over 100 every day.
  • Shunt operations for hydrocephalus cost over $1 billion a year in the US.
  • 50% of shunted individuals require a revising operation within two years.

For more information, visit our Shunt Systems page.
You can also download a PDF about shunting systems.

Endoscopic Third Ventriculostomy (ETV)

A second treatment option is a surgical procedure called endoscopic third ventriculostomy (ETV). An endoscope is used to puncture a membrane in the floor of the third ventricle creating a pathway for CSF flow within the cavities in the brain. ETV is an important alternative to shunting for obstructive hydrocephalus and may be useful in other cases as well.

Unlike many other operations in which the risks are highest during the surgical procedure, most problems associated with shunting occur weeks or even years afterward. Shunt obstruction and malfunction occur in approximately one third of children in the first year after a shunt-related operation and studies have shown that ETVs can close up after time. We cannot overstate the importance of learning the signs and symptoms of treatment failure. Staying in close contact with neurosurgeons if you have a shunt or an ETV is critical. Please click here to read about serious complications that you should be informed about.

For more information on ETVs, download a free pdf.