Brief Answer:
Depends on what you mean by SAFE

Detailed Answer:
Good evening and thank you for your question. Your partner's doctor likely told them what the safe amount is to drink under current circumstances and that amount is actually ZERO liters per night and more to the point ZERO MILLILITERS per night. Although I can't be sure without knowing much more about your partner's situation and any test results that have been obtained to this point but there are several mechanisms by which ACUTE INTRACRANIAL HYPERTENSION probably comes about from excessive alcohol consumption. One common way is for there to be bleeding either directly into the brain itself causing a subdural hematoma or into the ventricular system. Both of these can cause a sudden rise in the intracranial pressure and also cause problems with the shunt being able to do its job because of external compressive forces.

Bleeding into the brain or into the ventricles can come about as a result of a severe depletion in blood clotting factors which are produced by the liver. When alcohol is consumed in any amount this will trigger a reaction in the liver that will result in the decreased production of clotting factors. This in turn can result in spontaneous bleeds not just in the head but anywhere in the body.

Therefore, if that is the mechanism by which the acute intracranial hypertension is being produced then, the solution is to avoid all alcoholic beverages in any quantity. Any amount of alcohol will trigger the reaction of the liver to drop its production of clotting factors.

Another mechanism by which excessive alcohol consumption can cause acutely elevated intracranial pressure is by causing excessive fluid to accumulate around the brain. The way this happens is basically by again, affecting the liver to the point where proteins that are normally produced there and deposited into the bloodstream such as albumin, globulins, and others are just not present to any significant extent any more. What this does is to cause a very LOW OSMOTIC OR ONCOTIC PRESSURE INSIDE the blood vessels. In other words, the concentration of PROTEINS and other SOLID elements in the bloodstream is what we call the ONCOTIC PRESSURE. This is the pressure caused by the sheer presence of SOLID PARTICLES of matter inside a liquid medium (blood). What this pressure does is increase the likelihood or tendency of the blood to RETAIN ITS WATER COMPONENT inside the blood vessel. Once the concentration of solid elements in the bloodstream decreases to critical levels then, there is nothing solid anymore that will HOLD ON TO WATER inside the vessel and where does it go? It leaks out from the bloodstream and into whatever organ we're talking about. In other words, a sudden and MASSIVE EXODUS of water and other fluids will LEAVE the blood vessels and enter into whatever space or organ is at hand and that's how the patient can get FLUID AROUND THE BRAIN very quickly....REDUCED ONCOTIC PRESSURE considerations.

And so again, if alcohol is inducing a lack of protein production by the liver and this is resulting in a decreased ONCOTIC PRESSURE within the walls of the blood vessels then, the upshot is a massive EXIT of water and other fluids from the bloodstream passing through the brain and accumulation of this water on and in the brain itself. This will again RAISE PRESSURE inside the skull and cause the acute intracranial hypertension as well as cause compression of the shunt assembly to the point of not being able to clearly drain the excessive fluid that is circulating.

I know this is a difficult situation but your partner absolutely needs to be in a rehabilitation program for problem drinking and he needs it right away otherwise, he is likely to suffer very severe consequences from this amount of drinking and it's going to start really going down hill in a short period of time from now. Obviously, this is not an easy problem to deal with but I can tell you that it is the MAJOR THING your partner has to work on.

There is no SAFE amount of alcohol that can be consumed if the interest is to avoid acute intracranial hypertension in your partner.

If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my answers/suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic and others.

This query has utilized a total of 41 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Sorry that I wasn't clear

Detailed Answer:
My apologies that my explanation didn't seem to correlate with what your surgeon was saying but in fact, it does if you read it very carefully.

What I was trying to do was cover the bases of the possible mechanisms that could cause INCREASED INTRACRANIAL PRESSURE and how that all comes to be (i.e. damage to the liver). In other words, the ACT OF DRINKING, or to be more precise....the alcohol itself is not the toxic element that directly causes accumulation of fluid around the brain but rather it's the malfunction of the liver CAUSED by alcohol ingestion that causes the phenomenon of the brain to be compressed by fluid escaping from the blood vessels.

This is why ANY LEVEL of ingestion of alcohol is no good for this situation. If alcohol could be stopped then, perhaps the liver can recuperate over time in order to start producing the proteins and other elements that form the normal intravascular environment that could PREVENT or RETARD the extravasation of the fluid causing the brain and the shunt to be compressed and the hydrocephalus to continue.

Any level of drinking more alcohol can be fatal would be the bottom line here because increased pressure inside the skull that cannot be relieved by the shunt or by medications being given to reduce pressure can result in what is known as BRAIN HERNIATION and this is where the substance of the brain is pressed through any opening in the skull that is can go through. This usually causes at the very least strokelike damage if not death should the brain herniate through the foramen magnum.

I'm not sure which medications you refer to that "remove the desire to drink" because I am not aware of any such drugs that are currently on the market. There is a commonly used drug which is poorly effective which causes reactions with alcohol to the point of making the patient very sick. Theoretically, that type of reaction is supposed to habituate the patient into avoiding liquor but what I've found through experience is that such patients merely stop taking the medication that causes the bad reactions and that takes care of that problem....easy....

There is one medication which anecdotally is said in some patients to reduce cravings on a more permanent basis called NAD+ which is an IV infusion. I do work with this form of addiction treatment substance in a clinic locally. You may wish to look this treatment modaility up to see if such a clinic may be close to you. It is a pricey drug to be sure but different clinics may accept insurances, etc. so you'd have to check into it....but the bottom line is that in some patients I have seen some dramatic results of patients coming off of their alcohol in less than 10 days (outpatient procedure) and not going into any severe withdrawal, requiring a minimum of support from other drugs AND here's the kicker....I've seen some patients actually lose the urge or craving to drink after treatments are done in 10 days. Of course, there are a percentage of people who will always relapse and not respond but as I said, in the time I've been working in this particular clinic I've witnessed some very impressive results using these infusions not only for alcohol but for heroin, cocaine, prescription drug addicts, and other neurological disease entities.

Just look up NAD+ infusions. There are only a handful of clinics in the U.S. who carry these medications. It is not carried as far as I know as standard protocol in treatment or rehab centers likely due to pharmaceutical company pressures.

At this point if you can get your friend to stop drinking long enough to allow the liver to recharge a bit and start pumping up the bloodstream with what it needs to function then, the fluid on the brain and raised intracranial pressures will start to reverse themselves. As far as removing cravings, that is a different can of worms altogether and can be challenging but if you'd like to look up some information on the NAD+ infusions you can look up www.lunaliving.org (which is the clinic where I take care of patients) and there are research articles that talk about how NAD infusions are believed to be useful in treating these types of problem.

If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my answers/suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic and others.

This query has utilized a total of 65 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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