Patient's question:
My daughter, who is 1 year and 4 months old, was diagnosed with hydrocephalus and it was classified as mild to moderate supratentorial hydrocephalus. The doctor recommended first observing (if there is any worsening episodes) before considering surgery. Currently, the child has no symptoms, occasionally having a few twitches in the corner of the mouth, and intellectual development is basically normal. Is there any other better conservative treatment method?1 year and 4 months
Detailed medical history and consultation purpose: Hydrocephalus treatment plan (conservative plan)
Duration and onset of the current illness: 4 months ago, occasional twitching in the corner of the mouth
Current general condition: No symptoms, occasional twitching in the corner of the mouth
Medical history: None
Previous
Doctor's answer:
Hello: Hydrocephalus is divided into obstructive hydrocephalus and communicating hydrocephalus, with the former being more common. The traditional treatment for hydrocephalus currently is ventriculoperitoneal shunt surgery, which involves connecting the ventricles to the peritoneum using a silicone tube to allow the "accumulated cerebrospinal fluid" to flow into the peritoneum for absorption. This surgery can alleviate hydrocephalus to some extent, but a large number of clinical statistics show that the complications of ventriculoperitoneal shunt surgery are relatively high, with an incidence rate close to 50%. These complications include shunt tube blockage, dislodgement, rupture, intracranial infection, abdominal infection, abdominal discomfort, etc. Many patients often require secondary or even multiple surgeries. Moreover, as the child grows taller, the shunt tube needs to be adjusted continuously, which brings more suffering and financial burden to the patient. In recent years, it has been internationally recognized that the preferred treatment for obstructive hydrocephalus is endoscopic third ventriculostomy, which involves inserting an endoscope with a diameter only a fraction of a cigarette into the ventricle, under television surveillance, to create a hole with a diameter of about 0.5 cm at the bottom of the third ventricle. The "accumulated cerebrospinal fluid" flows out through this hole, thus relieving hydrocephalus. The advantages of this method are minimal trauma, good efficacy, and avoidance of repeated surgeries, making it more physiologically appropriate. Generally, isotope tests are required before surgery. If it is confirmed to be obstructive hydrocephalus, endoscopic surgery can be performed. Due to the high cost of equipment and the high technical requirements, only a few major hospitals in China are capable of performing such surgeries.