Assessment of fluid build-up in the brain, shunt problems, and endoscopic alternatives to a shunt.
The brain floats in cerebrospinal fluid, which is made continuously and continuously absorbed. When that circulation is blocked, or absorption fails, the fluid builds up and presses on the brain. That is hydrocephalus.
It occurs in babies, in children, and in adults. In older people a particular form called normal pressure hydrocephalus causes a distinctive combination of unsteady walking, memory difficulty, and loss of bladder control. It is important because it is one of the few causes of dementia-like decline that can genuinely be treated, and it is regularly mistaken for ageing or for Parkinson's disease.
Treatment drains or diverts the trapped fluid. The traditional method is a shunt, a fine tube running under the skin that carries fluid from the brain to the abdomen, where it is absorbed.
For suitable patients there is an alternative that avoids implanting a shunt altogether: endoscopic third ventriculostomy, in which a small opening is made through an endoscope to let fluid escape along a new route. Dr. Rana lists this procedure among his areas of expertise.
A shunt is a device, and devices fail. Blockage, infection, and over-drainage all occur, sometimes years after the original operation. The symptoms of a blocked shunt often resemble the symptoms that led to it being placed: headache, vomiting, drowsiness, or in children irritability and a head growing too fast.
Anyone with a shunt who becomes unwell in this way needs assessment promptly rather than waiting to see. If you have a shunt and are worried about it, bring your previous scans and operation notes.
Please note: NeuroMet Wellness is an outpatient clinic. Consultation, review of your scans, and second opinions happen here; if a surgery is advised, it is carried out by Dr. Rana at his hospital, Paras Health, Gurugram.
A form seen in older people, causing unsteady walking, memory difficulty and loss of bladder control. It matters because it is one of the few treatable causes of dementia-like decline, and it is often mistaken for ageing.
No. Some patients are suitable for endoscopic third ventriculostomy, which creates a new drainage route through an endoscope and avoids implanting a shunt at all.
Headache, vomiting, drowsiness or a return of the original symptoms can all indicate blockage, and in children irritability or a rapidly growing head. This needs prompt assessment rather than waiting.
The tube can stay for many years, but shunts need lifelong monitoring because blockage, infection and over-drainage can occur at any point, sometimes long after surgery.
Assessment and follow-up happen at NeuroMet Wellness. If shunt surgery or an endoscopic procedure is advised, it is carried out by Dr. Rana at his hospital, Paras Health, Gurugram.
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