There is currently no known way to prevent or cure hydrocephalus and the only treatment option today requires brain surgery. With early detection and appropriate intervention of hydrocephalus, the future for many is promising. Recent research is advancing knowledge and moving us closer to a cure. Advances in technology as well as diagnostic and treatment protocols are helping more and more people with hydrocephalus to lead full and active lives.
There are three forms of surgical treatment currently used to manage hydrocephalus.
The most common treatment for hydrocephalus—and the most common procedure performed by pediatric neurosurgeons in the United States—is the surgical implantation of a device called a shunt.
A shunt is a flexible tube placed into the ventricular system of the brain which diverts the flow of CSF into another region of the body, most often the abdominal cavity, where it can be absorbed. A valve within the shunt maintains CSF at normal pressure within the ventricles.
Endoscopic Third Ventriculostomy (ETV) and Endoscopic Third Ventriculostomy with Choroid Plexus Cauterization (ETV/CPC)
A second treatment option for hydrocephalus is a surgical procedure called endoscopic third ventriculostomy (ETV). This same ETV procedure with the addition of choroid plexus cauterization is available for infants. In the ETV procedure, 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. This approach is an important alternative to shunting for obstructive hydrocephalus and may be useful in other cases as well.
The third treatment option involves the addition of choroid plexus cauterization with endoscopic third ventriculostomy in infants. The neurosurgeon uses a device to burn or cauterize tissue from the choroid plexus. The choroid plexus is a network of vessels in the ventricles of the brain where cerebrospinal fluid is produced.
The success rate for ETV or ETV/CPC depends upon patient factors such as age, cause of hydrocephalus, and whether there is scarring in the fluid space below the floor of the third ventricle. For some patients, the chance for success of the ETV may be up to 90%; however, for others, ETV – with the addition of CPC for infants – may not be recommended because the chances for success are sufficiently low. Your neurosurgeon should be able to provide you with a reliable estimate of the likelihood for success in your particular situation prior to the operation. It’s critical that parents and patients understand that ETV is not always a permanent cure for hydrocephalus. Candid communication with your physician regarding the definition of success is important when considering ETV.