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Surgical Treatment of Intracranial Hypertension

Intracranial hypertension (IH) indicates excess buildup of cerebrospinal fluid (CSF) in the skull. This condition can be chronic or acute. Surgical intervention will depend on several factors.

  1. Surgery for Acute IH

    • Acute IH will always require surgery as it is triggered by things like severe injury and strokes. The swelling is rapid and severe, requiring immediate intervention. Surgery typically involves taking away a portion of the skull to relieve swelling and reduce fluid build-up.

    Surgery for Chronic IH

    • Chronic IH indicates fluid built up gradually over time that remains elevated. Doctors typically use medication as a first line of defense. You might require surgery if you risk vision loss, have unrelenting chronic pain or have not found relief with medication.

    Optic Nerve Fenestration

    • If your chronic IH is putting your vision in jeopardy, you will undergo optic nerve fenestration. This procedure relieves optic nerve pressure by draining the surrounding CSF.

    Shunt Procedures

    • Shunt procedures can treat both headaches and vision loss. Shunts redirect the fluid to another part of the body, reducing intracranial pressure. In most cases, they divert the fluid to the abdominal cavity but can also go to the chest and heart.

    Considerations

    • Surgery for chronic IH carries the risk of several serious complications. You might require repeat operations for a variety of reasons--the most common being the replacement of blocked catheters used with the shunts.

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