Abstract

Alternative surgical techniques in the treatment of hydrocephalus

Author(s): Valentin Titus Grigorean, Mircea Litescu, Anwar Erchid, Ionut Simion Coman, Iancu Emil Plesea

Hydrocephaly, or hydrocephalus, is a pathological condition characterized by an excessive Cerebrospinal Fluid (CSF) accumulation within the cerebral ventricular system that leads to intracranial hypertension. This elevated pressure, known as intracranial hypertension, has a detrimental effect on the brain’s structure and function. As a result, the “noble substance” of the brain will suffer due to the pressure exerted by the accumulated CSF.

The severity of symptoms and the long-term damage depend on the levels of intracranial pressure and the duration before treatment. Critical levels of intracranial pressure and delayed therapeutic measures will lead to irreversible neurological changes and, finally, to death if left untreated.

While surgical interventions are often necessary for moderate to severe cases, drug treatments may offer a viable alternative for managing milder forms of hydrocephalus or as an adjunct therapy.

The long-term experience with the various procedures discussed below led to the conclusion that the most effective and durable method is the Ventriculoperitoneal (VP) shunt, followed by the transjugular ventricular or Ventriculoatrial (VA) shunt.

Sometimes, drainage system dysfunctions and complications require iterative re- interventions and alternate solutions for the patient’s well-being become mandatory.

In conclusion, effective management of hydrocephalus requires a personalized approach, considering the patient’s condition and response to previous treatments. As the field continues to evolve, ongoing research aims to improve surgical techniques, reduce the risk of complications, and explore new treatment modalities. Close postoperative monitoring is significant to identify and address any complications, ensuring the best possible outcomes for patients with hydrocephalus.