Congenital and acquired hydrocephalus
Both congenital and acquired hydrocephalus usually require prompt treatment in order to reduce the pressure on the brain. If the pressure is allowed to rise, it will eventually damage the brainstem. The brainstem is the inner part of the brain that is responsible for regulating most of the automatic functions of the body that are essential for life, such as breathing and heartbeat.
Shunt
Hydrocephalus can be treated using a piece of surgical equipment called a shunt. A shunt is a thin tube that is implanted in the brain. The shunt drains away any excess fluid to another part of the body, usually the abdomen.
Once the shunt has been installed, further treatment for hydrocephalus is usually not required. Occasionally, the shunt can become blocked or infected and shunt repair surgery will be required.
See Complications, above, for more information about shunt malfunction and shunt repair surgery.
Normal pressure hydrocephalus
Normal pressure hydrocephalus (NPH) can also be treated with a shunt. However, experience has shown that not everyone with NPH will benefit from shunt surgery.
Because of the inherent risks of complications during surgery, it is necessary to carry out a number of tests to assess whether the potential benefits of surgery outweigh the risks.
One way of doing this is to carry out a lumbar puncture (LP). LP involves inserting a needle in to the base of the spine in order to remove some cerebrospinal fluid (CSF).
A few hours after the procedure, you will have a series of tests that focus on your gait and mental abilities. If both of these have improved, it is likely that you will benefit from having a shunt fitted.
A lumbar infusion test is an alternative way of assessing your suitability for shunt surgery. The test involves inserting a needle into your lower back, using a local anaesthetic, and injecting fluid into your spine. The pressure of the fluid around your spinal cord is measured before, during and after the injection of fluid.
The pressure of the fluid that is injected into your spine will be affected by the pressure of the CSF fluid pressing against it. By measuring this effect, it is possible to determine the pressure of the CSF.
Health professionals have found that surgery is likely to be beneficial if the pressure of the CSF is above a certain limit. However, if it is below that level, surgery will probably not be of any benefit.
If testing reveals that a shunt would be beneficial, the shunt will be fitted in the same way as for congenital and acquired hydrocephalus.
