What is the treatment for non-communicating hydrocephalus?

Treatment for non-communicating hydrocephalus typically involves surgical intervention to create a pathway for the cerebrospinal fluid (CSF) to flow and relieve the pressure on the brain. Here's an overview of the common surgical treatments:

1. Endoscopic Third Ventriculostomy (ETV): This is the preferred treatment for non-communicating hydrocephalus. It involves creating a small hole in the floor of the third ventricle, which is one of the fluid-filled cavities in the brain. This allows CSF to flow directly from the ventricles into the subarachnoid space, bypassing the obstructed pathways.

- Procedure: ETV is performed using an endoscope, a small, flexible camera inserted through a tiny incision in the skull. The neurosurgeon uses the endoscope to visualize the ventricles and create the opening in the third ventricle floor.

- Benefits: ETV is minimally invasive, has a relatively high success rate, and is associated with fewer complications compared to other surgical options.

2. Ventriculoperitoneal Shunt (VPS): A ventriculoperitoneal shunt is another common treatment. It involves placing a thin, flexible tube (shunt) to drain CSF from the ventricles and redirect it into the peritoneal cavity, which is the space in the abdomen.

- Procedure: A shunt is inserted into the ventricles through a small incision in the skull. The other end of the shunt is tunneled under the skin and placed in the peritoneal cavity. A one-way valve in the shunt regulates the flow of CSF.

- Benefits: VPS is an effective treatment for long-term control of hydrocephalus. It can be adjusted or revised if necessary.

3. Choroid Plexus Cauterization (CPC): This procedure is sometimes used in cases of non-communicating hydrocephalus caused by excessive production of CSF. It involves cauterizing (burning) the choroid plexus, which are the structures in the ventricles that produce CSF.

- Procedure: CPC can be performed during ETV or as a separate surgery. The neurosurgeon uses an endoscope to access the choroid plexus and cauterize it with an electrical instrument.

- Benefits: CPC can help reduce CSF production and alleviate the pressure on the brain.

The choice of surgical treatment depends on several factors, including the underlying cause of hydrocephalus, the patient's age and overall health, and the neurosurgeon's expertise and experience. Regular follow-up and monitoring are necessary after any surgical intervention for non-communicating hydrocephalus.