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Published: August 8, 2023

What are the available choices for Pediatric Hydrocephalus Treatment?

When it comes to pediatric hydrocephalus treatment, there are several options available. Hydrocephalus is a condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) in the brain, which can lead to increased pressure and potential brain damage. In this article, we will explore the different treatment options for pediatric hydrocephalus and discuss the importance of early detection and prompt treatment.

Different Types of Pediatric Hydrocephalus:

Pediatric hydrocephalus can be classified into two main types: obstructive hydrocephalus and normal pressure hydrocephalus (NPH). Obstructive hydrocephalus occurs when there is a blockage in the flow of CSF, while NPH is characterized by the impaired absorption of CSF. It is important to accurately diagnose the type of hydrocephalus in order to determine the most appropriate treatment approach. 

The article discusses various treatment options for hydrocephalus, a condition characterized by an accumulation of cerebrospinal fluid in the brain. The main treatment options mentioned are the shunt system, endoscopic third ventriculostomy (ETV), and endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC). The shunt system involves surgically implanting a device to redirect the flow of fluid, while ETV creates a pathway for fluid to pass between brain cavities. ETV/CPC combines the cauterization of choroid plexus tissue with the ETV procedure. The success rate of these treatments depends on patient factors such as age and the cause of the condition. It is important to note that ETV does not provide a permanent solution for hydrocephalus. Early detection and prompt treatment are crucial to prevent severe health complications associated with hydrocephalus. The article also mentions advancements in knowledge and technology that are improving diagnostic and treatment procedures for hydrocephalus. However, there is currently no verifiable method of curing or preventing hydrocephalus, making treatment the most viable option for patients.

Options for Treating Hydrocephalus:

1.Shunt System:

The shunt system is the most popular treatment option for hydrocephalus. It involves the surgical implantation of a shunt device, which is a flexible tube that redirects the flow of CSF from the brain to another area of the body, where it can be absorbed. The shunt has a valve that helps maintain the appropriate pressure of CSF. This procedure is commonly performed by pediatric neurosurgeons in the US.

2.Endoscopic Third Ventriculostomy (ETV):

The ETV procedure is a surgical technique that uses an endoscope to create a pathway for CSF to pass between brain cavities. It involves making an incision in the membrane on the floor of the third ventricle. ETV is an alternative to the shunt system for obstructive hydrocephalus and may also be applicable in other situations. However, it is important to note that ETV does not provide a permanent solution for hydrocephalus.

3. Endoscopic Third Ventriculostomy with Choroid Plexus Cauterization (ETV/CPC):

ETV/CPC is a procedure specifically designed for pediatric hydrocephalus treatment. It involves cauterization of choroid plexus tissue, which is responsible for producing CSF. This procedure is performed in combination with the ETV procedure and can improve the success rate in certain cases. However, the success rate varies based on patient factors such as age and the cause of the condition.

Treatment Options for Normal Pressure Hydrocephalus:

In addition to the aforementioned treatment options, there are specific approaches for treating NPH. These include the use of shunt systems and endoscopic procedures, similar to those used for obstructive hydrocephalus. The choice of treatment depends on the individual patient's condition and should be discussed with a neurosurgeon.

Normal pressure hydrocephalus (NPH) is a condition characterized by an abnormal buildup of cerebrospinal fluid (CSF) in the brain's ventricles. However, unlike other forms of hydrocephalus, the pressure within the ventricles remains within the normal range.

NPH typically occurs in older adults, and its exact cause is often unknown. However, it can be associated with conditions such as head trauma, brain hemorrhage, infection, or tumors. The buildup of CSF in the ventricles can lead to the compression of surrounding brain tissue, resulting in a variety of symptoms.

The classic symptoms of NPH are often referred to as the "triad" and include:

Gait disturbance: This usually manifests as difficulty walking, with patients often having a shuffling or hesitant gait. They may experience balance problems and may have trouble turning or changing direction.

Cognitive decline: Patients with NPH may experience memory loss, confusion, and difficulties with attention and executive functions. They may have trouble finding words or following conversations.

Urinary incontinence: Many individuals with NPH develop urinary urgency, frequency, or difficulty fully emptying the bladder. This can lead to accidents or frequent trips to the bathroom.

Other symptoms that may accompany the triad include headaches, dizziness, changes in mood or behavior, and problems with coordination or fine motor skills.

Diagnosis of NPH involves a thorough neurological examination, a review of symptoms, and imaging tests such as a brain MRI or CT scan. Lumbar puncture, or spinal tap, may also be performed to measure CSF pressure and to help determine if draining excess fluid can improve symptoms.

The main treatment for NPH is surgical intervention, typically in the form of a ventriculoperitoneal shunt. This involves the placement of a tube (shunt) into the ventricles to divert excess CSF to the abdominal cavity, where it can be reabsorbed. Shunt surgery can often lead to significant improvements in symptoms, particularly if the condition is diagnosed and treated in its early stages.

Overall, NPH is a relatively rare condition, and its symptoms can often be mistaken for other neurological disorders. Therefore, it is important for individuals experiencing the triad of symptoms to seek medical evaluation to determine the underlying cause and appropriate treatment.

Hydrocephalus Treatment for Infants and Children in New Jersey

At the New Jersey Pediatric Neuroscience Institute (NJPNI), we specialize in providing comprehensive care for infants and children with hydrocephalus. Our team of experienced neurosurgeons and specialists are dedicated to delivering the highest quality treatment options tailored to each patient's needs. We emphasize the importance of early detection and prompt treatment to prevent severe health complications and optimize the child's future.


Hydrocephalus is a complex condition that requires specialized treatment. The available treatment options for pediatric hydrocephalus include the shunt system, ETV, and ETV/CPC. It is important to consult with a neurosurgeon to determine the most suitable treatment approach based on individual patient factors. Early detection and prompt treatment are crucial for preventing potential brain damage and ensuring a promising future for hydrocephalus patients. At NJPNI, we are committed to providing the best possible care for infants and children with hydrocephalus, utilizing advancements in knowledge and technology to improve outcomes and enhance their quality of life.

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NOTICE: This website is for informational purposes only and is not intended as medical advice or as a substitute for a patient/physician relationship.

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