Hydrocephalus & Shunt Surgery Treatment at CritiCare Asia Hospitals, Malad, Mumbai
When a baby's head seems too large, or an older parent starts walking unsteadily and forgetting things, families rarely know that one treatable condition may lie behind it. CritiCare Asia Hospitals, Malad is a neurology hospital in Mumbai where hydrocephalus is assessed with the whole family in mind. The brain rests in a cushion of cerebrospinal fluid (CSF) that is made and absorbed all the time. When this balance is disturbed, fluid collects in the brain's ventricles and presses on delicate tissue. Hydrocephalus treatment in Malad, Mumbai is available for infants, children and adults, and it starts by finding out why the fluid has built up.
Types of Hydrocephalus
- Communicating
fluid circulates freely between the ventricles but is not absorbed properly. - Obstructive
a tumour, cyst or narrowing blocks the usual fluid pathway. - Normal pressure hydrocephalus (NPH)
develops slowly, mainly in older adults, and measured pressure can appear normal. - Congenital or acquired
either present from birth, or the result of infection, bleeding, head injury or a tumour.
Symptoms by Age
What a family notices depends on the age of the patient, and this is why the condition is sometimes overlooked.
- In infants
a head that grows quickly, a tight or bulging soft spot, constant vomiting, irritability and eyes that appear to look downwards. - In older children and adults
headaches, often worst on waking, together with nausea, blurred or double vision, sleepiness and poor balance. - In NPH
an unsteady, shuffling walk, memory and thinking that decline, and loss of bladder control, all of which are easily put down to old age or dementia.
What Causes It
Premature birth with bleeding in the brain, a developmental problem of the brain or spine, or an infection can lead to hydrocephalus in infants. In adults, it commonly follows a brain haemorrhage, a head injury, meningitis or a tumour that blocks the fluid pathway. At times no cause can be found, especially in older people with NPH. Understanding the cause matters because it decides whether a shunt, a ventriculostomy, or simple observation is right, and that decision comes before hydrocephalus surgery in Malad, Mumbai is planned.
Diagnosis
Examination and imaging are the basis of diagnosis. Ultrasound can be done through the soft spot in babies, while CT and MRI reveal enlarged ventricles and may point to the cause. An eye examination can show swelling of the optic nerve, and a child's head size is measured over time. When NPH is suspected, a controlled drainage of CSF through a lumbar puncture shows whether walking and thinking improve.
Treatment Options
Medicines cannot cure hydrocephalus, so treatment for fluid build-up in the brain is surgical. A shunt carries excess cerebrospinal fluid away to another part of the body, usually the abdomen, and is known as a ventriculoperitoneal (VP) shunt. For selected patients, endoscopic third ventriculostomy (ETV) creates a small opening inside the brain so that fluid can escape without a shunt.
VP Shunt Surgery
- Before surgery
scans are reviewed, blood tests and an anaesthetic assessment are arranged, and fasting instructions are given. Relatives are told honestly that a shunt is generally a lifelong device and what risks it carries, and they are welcome to ask questions at this stage. - During surgery
general anaesthesia is given, a thin catheter is passed into the ventricle through a small opening in the skull, and it is led under the skin to the abdomen, where the body absorbs the fluid and pressure in the head falls. Some patients may be given a programmable valve, which can be adjusted afterwards with an external magnetic device and without another operation, useful when too much or too little fluid is draining. - After surgery
the patient is monitored in hospital, wound care is explained and normal activity returns gradually. Follow-up visits include scans and, for programmable valves, a check of the setting. Families are taught the signs that a shunt may be failing, so they know when to call. Headaches and other symptoms often settle as pressure normalises, though speed varies from one person to the next.
Revision Shunt Surgery
A shunt is a mechanical device, and over the years it may need attention. Reasons include:
- A blocked catheter or valve
- Tubing that has come apart or broken
- Infection
- Draining too much or too little, causing headaches or a return of earlier symptoms
- Tubing that a growing child has outgrown
Warning signs are the return of headache, vomiting or drowsiness, or fever, redness or swelling along the shunt track. A revision may replace one blocked part or the entire system. An infection usually needs antibiotics and, often, temporary removal of the shunt with external drainage before a new one goes in.
Hydrocephalus & Shunt Surgery Treatment at CritiCare Asia Hospitals, Malad, Mumbai
A shunt stays with a patient for years, so the team that plans it should still be there to review it. At CritiCare Asia Hospitals, Malad, care starts by working out why fluid has built up, and the neurosurgical team explains the options to the family in plain terms, including what a shunt can and cannot do. Children and adults are managed differently, since a growing child's shunt needs a different long-term watch from an older adult's. Follow-up visits are regular, and the same team stays involved if the shunt later needs attention. If your child has a shunt and the old symptoms are coming back, or you suspect hydrocephalus in someone you love, bring them to CritiCare Asia Hospitals, Malad, and speak with a neurosurgeon in Mumbai.