Saturday, October 6, 2012

Day Six: Hydrocephalus and Shunts

Welcome to 31 Days of Spina Bifida Awareness Day 6!
Hydrocephalus, which in simple terms is excess cerebrospinal fluid accumulating in the brain, can occur in children who do not have Spina Bifida.  It often comes with Spina Bifida Myelomeningocele.  Mason developed hydrocephalus during the last few months of pregnancy.  In a normal person the CSF flows from the brain to the spinal column.  When Mason’s spinal cord grew out of place it pulled on his brain as it formed.  Instead of growing centered in the skull his brain grew tugged back and even down into the cervical vertebrae, clogging up the pathway the CSF would normally flow through and causing this to back up in the brain (hydrocephalus). 
The brain and skull do not absorb excess fluid so this begins to put pressure on the brain.  Pressure on the brain left untreated causes brain damage and possible death.  Surgeons often relieve this by placing a shunt.  The shunt drains excess CSF into an area of the body that absorbs excess fluid and disposes of vpshuntA basic shunt has 3 parts: Tubing into the brain, a valve, and tubing into the abdomen.  These tubes are tiny in diameter and very flexible.  They can get clogged by cells and need replaced or the valve can malfunction.  Fixing or replacing a shunt is called a revision and neurosurgeons consider it to be a fairly routine brain surgery.  Yeah, I think the words routine and brain surgery should never go in the same sentence either.

A Piece of Our Story

100_8156Mason had his original shunt placed when he was one week old.  He came away with a crescent-shaped scar on his head, a lump under the skin of his head where the valve is, and a small scar on his abdomen where the doctor checked the placement of the abdominal tube’s end.  In the beginning you could literally see and feel the tube under the skin going down his neck and on his chest and abdomen.  He will always have a lump under the skin on his head where the valve is, but as his hair grows it becomes much less noticeable. 
Shunt Failure:  One day 6.5 months later Mason did nothing but fuss, eat, throw up, and sleep.  He wasn’t himself and I started to wonder – was it his shunt  or was he just sick?  It’s not a fun question to ponder.  In the middle of the night his fontanel (soft spot) on his skull started to bulge and I knew it was the shunt.  I knew we were looking at another brain surgery.  After scans and tests the doctors were not convinced but relying on mother’s instincts into surgery they went.  You can read the rest of the story HERE.  It turned out the tube going from the valve into his brain was clogged.  It was replaced and Mason is doing just fine today. 
I am grateful every day for the medical knowledge God has given in this day and age.  They certainly don’t know everything, but they can help with many things.  Even 60 years ago Mason would likely have died – either from infection getting in through his back or from untreated hydrocephalus.

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