Hydrocephalus is a disorder that is characterized by a buildup of excess cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain. Pediatric hydrocephalus is one of the most common developmental disabilities, affecting an estimated 1 in 500 children. It has also been estimated that 700,000 individuals are currently living with chronic hydrocephalus today.
Above is a CT scan of a hydrocephalic brain showing the expansion of the ventricles.
Hydrocephalus can present with many different symptoms. In infants, symptoms can range from mild irritability and sleepiness to more severe symptoms, such as seizures, vomiting. Most noticeably, hydrocephalic infants will develop a bulging and abnormally large head, which occurs because infants’ skulls will expand to help accommodate the excess CSF.
In older children and adults hydrocephalus may present with a different host of symptoms, because their skulls cannot deform to accommodate the excess CSF. These symptoms include issues with walking, urinary incontinence, and progressive mental impairment and dementia.
If left untreated, hydrocephalus can lead to permanent brain damage, loss of physical and/or mental ability, and even death. It is important to have hydrocephalus treated promptly after diagnosis.
This depends on the type of hydrocephalus that you have. There are two major classes of hydrocephalus: communicating or non-communicating.
Communicating hydrocephalus: (aka non-obstructive hydrocephalus) This is caused by the brain’s impaired ability to reabsorb CSF, and there is no visible obstruction between the ventricles and the subarachnoid space. In such cases of hydrocephalus, the only real long-term management option is the surgical implantation of a ventriculoperitoneal shunt device. These shunts have two ends: a proximal end that is inserted into the ventricles of the brain, and a distal end that drains the excess hydrocephalus from the ventricle into the peritoneum (the lining around the stomach). Here, the CSF may be naturally reabsorbed.
Non-communicating hydrocephalus: (aka obstructive hydrocephalus) In cases of obstructive hydrocephalus, there is some sort of blockage obstructing appropriate drainage of CSF from the ventricles. The blockages most commonly occur within the cerebral aqueduct in the midbrain, which represents the smallest path that CSF must pass through on its way to exiting the ventricles to the subarachnoid space, where it can be reabsorbed. Typical blockages result from congenital defects or tumor growth. In such cases, a patient may be eligible for a different type of surgical procedure, called a third ventriculostomy. This procedure involves the surgeon puncturing a small hole within the base of the brain’s third ventricle, allowing the CSF an alternate route through which it may reach the brain’s reabsorption site. Though this procedure has very high success rates for long-term hydrocephalus treatment with no need for permanently implanted hardware, only a portion of patients with non-communicating hydrocephalus meet the eligibility criteria to receive this treatment. In patients that do not meet third ventriculostomy eligibility, shunt implantation surgery is used as well.
Above is a typical shunt setup used to drain excess CSF from the brain.
Although there are many different types of shunt systems on the market, the differences between most of them lie only in the small details. For example, different shunt systems may offer large or small catheter diameter sizes, different types of valves (anti-siphon, externally adjustable, high pressure flow or low pressure flow) or different hole patterns along the proximal end responsible for draining CSF out of the brain ventricle. Aside from the Inflatashield, other shunt systems are largely comparable. Your surgeon will likely choose the one that best suits your individual needs.
Among the many different shunt systems on the market, the Inflatashield shunt system offers something that no other systems currently do: an active obstruction blocking mechanism. Current shunt systems have over a 50% failure rate, largely due to obstruction in the proximal tip. In cases of shunt failure, revision surgeries are generally necessary for shunt replacement, which can present high risk for brain hemorrhages, infections, or further shunt complications. (Click here for more information on current shunt technologies.) Our device provides an extra line of defense against proximal end obstruction, and can potentially save a patient many of the revision surgeries that currently face chronic hydrocephalus patients who rely on traditional shunt systems for CSF drainage.
REBL Innovations 2011