Adult Hydrocephalus Care
Hydrocephalus is a complex neurological condition that affects 1 million Americans. It is a condition in which cerebrospinal fluid (CSF) accumulates in the ventricles of the brain, usually through an obstruction of the flow of CSF, or the failure of the body to reabsorb the CSF. If it is not present at birth or in childhood, hydrocephalus may develop in adults.
AHN Adult Hydrocephalus Center
The AHN Adult Hydrocephalus Center is focused on providing state-of-the-art care for our patients in the evaluation, diagnosis, and medical and surgical treatment of hydrocephalus. The multidisciplinary approach is important given the common symptoms associated with adult onset hydrocephalus, such as difficulty walking or memory trouble. These symptoms can be caused by a variety of other medical conditions, not specifically hydrocephalus. By a thorough medical and physical examination, other causes of these symptoms may be identified and treated, thus protecting patients from unnecessary invasive tests or unindicated surgical treatment. Our multidisciplinary approach ensures patients who have hydrocephalus are afforded the best chance of reducing their symptoms and improving their quality of life.
Symptoms of hydrocephalus
Hydrocephalus can have many causes including tumors, bacterial infections such as meningitis, hemorrhaging or bleeding within the brain, and traumatic injury. At times, no definitive cause can be identified. There are many types of hydrocephalus that can affect adults and all can present with different types of symptoms, including:
- Memory problems, particularly short-term memory
- Inability to perform simple tasks
- Frequent falls
- Shuffling gait
- Urinary incontinence (loss of bladder control
- Visual disturbances
At the AHN Adult Hydrocephalus Center, patients receive comprehensive medical care by our multidisciplinary team who specialize in the diagnosis and management of hydrocephalus.
A comprehensive evaluation of patients with symptoms of hydrocephalus is necessary to analyze the broad spectrum of symptoms that may occur with this condition. A comprehensive evaluation includes:
- A thorough medical history
- Detailed physical examination including baseline cognitive evaluation, motor assessment, balance assessment, and standardized gait assessment
- An analytical review of the patient’s imaging to aid in diagnoses and to assist in determining whether additional imaging or testing is warranted to guide treatment
- Procedural testing including possibly a Lumbar Tap Trial (LTT) to determine whether the symptoms improve after a large volume of spinal fluid is indicated
- Laboratory analysis of CSF to assist in diagnosis of any inflammatory, infectious, or tumor processes
- Nuclear Medicine Shunt Studies and Lumbar Cisternograms to evaluate the functions of already present CSF devices, including ventricular and lumbar shunt systems if indicated
If you are diagnosed with hydrocephalus, treatment options consist of symptom management with medication or surgical procedures to reduce the accumulation of fluid in the brain.
There are medications that can help minimize some of the symptoms of hydrocephalus, specifically in terms of memory difficulties and urinary incontinence. These medications will be discussed with you during your initial visit and will continue to be discussed throughout your appointments with your primary care physician and your neurologist. Physicians and staff at the AHN Adult Hydrocephalus Center will work closely with your primary care physician in order to best manage your hydrocephalus.
The two types of surgical procedures effective in treating hydrocephalus are cerebrospinal (CSF) shunting and endoscopic third ventriculostomy (ETV).
Endoscopic Third Ventriculostomy (ETV)
This approach is a surgical alternative to the shunt. In an ETV, an endoscope is introduced through a small hole in the skull into the third ventricle of the brain where a perforation is made in a membrane to restore normal flow of CSF. The entire procedure is performed using video guidance, and no device or hardware is implanted in the body. If successful, no revisions or replacements are necessary, and subsequent hospitalizations are markedly reduced. All patients with hydrocephalus in need of surgical treatment should be evaluated to see if they are eligible for an ETV prior to proceeding with shunt placement.
Cerebrospinal fluid shunting
The treatment of hydrocephalus generally focuses on diverting CSF buildup away from the head by way of surgically placed tubes called shunts. Though effective, shunts require open surgery with incisions in both the scalp and abdomen. Patients with shunts should be regularly seen by a neurosurgeon so that they can be monitored to ensure proper shunt function.
AHN Adult Hydrocephalus Center
320 East North Ave.
South Tower, 6th Floor
Pittsburgh, PA 15212