Patient's question:
My mom hasn't been able to cook recently and often says she has a headache and feels dizzy. The thing is, I don't really know what's going on, but she just seems quite unwell. Could you please tell me how many treatments are available for hydrocephalus?Doctor's answer:
Analysis of the Condition: Hydrocephalus can generally be divided into three types of treatment: pharmacological, surgical, and traditional Chinese medicine.Guidance: Non-surgical treatment is suitable for early stages or mild conditions with slow progression. The methods include:
(1) Using diuretics or dehydration agents, such as acetazolamide, hydrochlorothiazide, furosemide, and mannitol.
(2) Repeated lumbar puncture or anterior fontanelle puncture for fluid drainage.
Surgical Treatment: Surgical intervention is recommended for progressive hydrocephalus with significantly enlarged skulls and cerebral cortex thickness exceeding 1 cm. The surgical options include:
1. Procedures to reduce cerebrospinal fluid (CSF) secretion: Ependymoid resection followed by cauterization, which is now rarely used.
2. Surgical correction of ventricular obstruction: Such as aqueductoplasty or dilation, foramen magnum trephination, and resection of intracranial space-occupying lesions.
3. CSF shunt surgery: The goal is to establish a CSF circulation pathway to relieve CSF accumulation, applicable to both communicating and non-communicating hydrocephalus. Common shunt procedures include lateral ventricle-to-cisterna magna shunts, third ventricles fenestration, lateral ventricle-to-abdomen, superior sagittal sinus, right atrium, and external jugular vein shunts.
Traditional Chinese Medicine Treatment: Acupuncture and moxibustion for this condition have not been found in ancient medical texts. Modern reports first appeared in 1959, describing a case where a child was cured through acupuncture at points like Weizhong and Hegu. Subsequently, from the 1970s onwards, the acupuncture community began to pay attention to the treatment of this condition. In the past decade, there has been an increasing number of clinical studies with larger sample sizes, not only experimenting with various stimulation methods such as acupuncture combined with warm moxibustion using mugwort, herbal thread cauterization, and topical herbal application but also conducting in-depth exploration of clinical syndrome differentiation and treatment patterns. Preliminary findings suggest that from a TCM perspective, patients with kidney yang deficiency respond well to acupuncture, while those with spleen and kidney yin deficiency show poorer outcomes. From a Western medical classification, acupuncture has been found to be highly effective in treating communicating hydrocephalus with stable long-term results, whereas it is less effective in obstructive hydrocephalus with poor prognosis.