Hydrocephalus is a neurological disease that affects the circulation of cerebrospinal fluid, accumulating for various reasons in the cavities of the head known as ventricles. When these ventricles are enlarged (overflowing with fluid) we speak of hydrocephalus.
The treatment, therefore, consists of helping the brain to empty the fluid-filled ventricles. A tube (or catheter) is used to carry fluid from the enlarged ventricle to another cavity outside the head, such as the abdomen or lung (where the fluid is more easily absorbed). Between both ends of the catheter a “valve” or system is placed that allows the fluid to always follow the outflow direction (and not re-enter the brain).
What is the procedure of implanting a valve for a child with hydrocephalus?
Valve placement is a surgery that requires general anesthesia. The valve has three parts: a proximal tube or catheter that is lodged in the cerebral ventricles, the valve itself that is placed as an intermediate step between the proximal catheter and the distal catheter (usually placed under the skin behind the patient’s ear); and finally the distal catheter or tube that is introduced into some cavity of the organism:
- When we place them in the abdomen the valvular is known as “ventriculo-peritoneal shunt”.
- When the distal catheter is placed in a vein of the heart it is known as “ventriculo-atrial shunt”.
- If it is placed in the lung cavities it is called “ventriculo-pleural shunt”.
What safety measures should the parents of a child with a valve take?
The most frequent complications after valve placement are observed during the first months after implantation and are usually related to the surgical wound. The recommendations to be followed at home are the same as for other wounds.
It is important to note that children with hydrocephalus treated with a valve can play and enjoy themselves like any other child without this treatment.
What to do if the valve breaks down
Valves can also go bad, become disconnected or break. These are not common events with today’s devices, but they can happen.
Usually, at the time of discharge, the Neurosurgery specialist will inform you of the “alarm” symptoms of malfunction.
If any of these symptoms appear, parents should see their child’s pediatrician for urgent medical evaluation.
Periodic check-ups of the child with hydrocephalus
Patients who have undergone hydrocephalus surgery require a follow-up consultation with their neurosurgeon. During the first year, check-ups are more frequent to verify the correct functioning of the system.
Is the valve permanent or can it no longer be needed?
The valve is a system that in the vast majority of people is permanent, since the causes that led to its placement, i.e. hydrocephalus, persist over time. Occasionally, and especially during a malfunction of the system, endoscopic treatment of the hydrocephalus can be performed and the valve removed forever. Unfortunately not all patients tolerate this change of treatment.
Hydrocephalus causes dementia in adults – true or false?
Adult hydrocephalus is characterized by three major symptoms, which are usually progressive.
It begins with alterations in walking, then is accompanied by sphincter disturbances and finally memory disorders.
Adult hydrocephalus is one of the few causes of dementia that can be treated at present. Most of these symptoms disappear with the placement of a valve.