Before considering treatment for hydrocephalus, it is key that we understand why you have hydrocephalus (see information on hydrocephalus).
For obstructive or non-communicating hydrocephalus, it can be possible to relieve the hydrocephalus by relieving the point of obstruction or bypassing the CSF around it. The cause of a blockage in low of CSF might be caused by an abnormality such as a tumour which surgery to remove it could thereby relieve the hydrocephalus. However, there can be other congenital obstructions to CSF flow, the most common of which is a condition called aqueduct stenosis. This is best treated by bypassing CSF flow and the most common procedure for this is an endoscopic 3rd ventriculostomy. This involving puncturing a hole through the floor of the 3rd ventricle (one of the fluid spaces containing CSF), so CSF can thereby bypass to the surface of the brain from where it can be absorbed away. An endoscopic 3rd ventriculostomy is a relatively straightforward procedure done through a burr hole in your skull and using an endoscope to guide the procedure through the ventricular anatomy of the brain. It will usually just involve one or two days in hospital if successful. It often provides a long-term cure for hydrocephalus, although on occasion they can close over and the procedure needs to be repeated.
If the cause of hydrocephalus is impaired absorption of CSF, then no procedure to bypass CSF flow is going to help this. In this situation, a shunt is the surgical treatment of choice. This involves taking CSF from one of the ventricles in the head and taking it usually to the abdominal cavity from where it can be absorbed away.
A ventricular peritoneal (VP) shunt is a relatively straightforward operation which allows this diversion of CSF. A small piece of tubing is placed into the ventricle in the brain and then connected to a valve which characteristically sits in pocket of skin behind the ear. This valve will regulate the amount of CSF that is passed through the shunt as well as ensuring that the flow is only one way. It also provides a point of access whereby CSF can be drawn off the shunt if required. The valve is then connected via a further piece of tubing running underneath the skin down through the neck, over the chest wall and to the abdomen. A VP shunt usually only requires a 1 to 2-day stay in hospital.
Whilst a VP shunt is an excellent way of treating hydrocephalus, it can be associated with its own set of problems. These include shunt blockage, infection, and/or over-drainage. If a shunt is likely to be required, your surgeon would clearly outline the nature of these risks in far greater detail.