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Pediatric Neurosurgery
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CONDITIONS TREATED

Hydrocephalus

Hydrocephalus is the most common condition encountered in Pediatric Neurosurgery and results from a buildup of cerebrospinal fluid (CSF) in the brain, either from obstruction of the normal flow of spinal fluid, or more commonly, from reduced absorption of spinal fluid. This buildup of fluid results in enlargement of the ventricles, the fluid cavities of the brain. Hydrocephalus causes a rise in intracranial pressure, which when left untreated, can be fatal or result in severe neurologic impairment.

Common causes of hydrocephalus include brain hemorrhages, spina bifida, meningitis and brain tumours. Most cases of hydrocephalus are treated with a shunt- a device that drains spinal fluid from the ventricle through a small tube, carrying the fluid to the abdomen (a ventriculoperitoneal shunt). Occasionally fluid can be drained to the lungs (ventriculopleural shunt) or the heart (ventriculoatrial shunt). Shunts have a relatively high failure rate and so it is not uncommon for shunts to require replacement.

For selected cases of hydrocephalus, a minimally invasive procedure known as an endoscopic third ventriculostomy can be performed. In this procedure, a small fibre-optic camera is passed into the ventricles and a hole made in the floor of the third ventricle. This bypasses the blockage of spinal fluid and re-establishes the normal flow of CSF. The advantage of third ventriculostomy is that when successful, a shunt is not required. Endoscopic third ventriculostomy can be used to treat hydrocephalus caused by conditions such as aqueductal stenosis, tectal and pineal region tumours, posterior fossa tumours and selected cases of post-hemorrhagic hydrocephalus).


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