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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does Hydrocephalus Require A Permanent Shunt Or Is It Discarded Once Cured?

My fiance's newborn nephew was born at least 4 weeks premature and is about 30 days old now. He's in a remote area of the Philippines where the local medical expertise level is not very high. There is one neuro-surgeon in the whole province. He's been diagnosed with Hydrocephalus. He has had at least 2 seizures. They believe the hydrocephalus is caused by a bacterial infection, which they are still fighting with antibiotics. Recently after a big seizure, that they're surprised he survived, the doctors limited how often he is allowed to eat. The reason is they fear hiccups will cause another seizure. I'm told he's now very thin and weak, he's going up to a whole day at a time without feeding. His weight was the same as his birth weight, 2.3kg, a few days ago. It's possibly lower now. 2 questions: Is a hiccup from feeding actually likely to cause a seizure? Is a shunt always required for hydrocephalus, or might it go away when the infection is cured?
Mon, 6 Oct 2014
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Pediatrician,  's  Response
Thanks for asking on HealthCareMagic. I have gone through the query carefully. Let me tell you that the inner lining of the ventricles of the brain (that contain CSF and provide nutrition to the brain), is friable and can get damaged easily. In case of meningitis which is an infection of the coverings of the brain, the situation could get further complicated giving rise of blockage of the drainage system of the CSF and due to the built up of the pressure give rise to hydrocephalus. Even if the infection gets controlled, the blockage is likely to persist and hence the hydrocephalus requires shunting.
The seizures are caused due to nerve stimuli short circuiting in the damaged parts of the brain (where the damages may be caused either due to the prematurity or due to the infection). The hiccups could actually seizures that are being mistaken as hiccups but are actually aberrant brain stimuli that are causing the diaphragm to contract forcibly. Hence, they are likely to be not triggers but effect of seizures.
After birth, the weight of the baby generally comes down but resumes subsequently so you need not worry about that.

I hope that helps. Feel free to revert back in case of further queries if any.
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Does Hydrocephalus Require A Permanent Shunt Or Is It Discarded Once Cured?

Thanks for asking on HealthCareMagic. I have gone through the query carefully. Let me tell you that the inner lining of the ventricles of the brain (that contain CSF and provide nutrition to the brain), is friable and can get damaged easily. In case of meningitis which is an infection of the coverings of the brain, the situation could get further complicated giving rise of blockage of the drainage system of the CSF and due to the built up of the pressure give rise to hydrocephalus. Even if the infection gets controlled, the blockage is likely to persist and hence the hydrocephalus requires shunting. The seizures are caused due to nerve stimuli short circuiting in the damaged parts of the brain (where the damages may be caused either due to the prematurity or due to the infection). The hiccups could actually seizures that are being mistaken as hiccups but are actually aberrant brain stimuli that are causing the diaphragm to contract forcibly. Hence, they are likely to be not triggers but effect of seizures. After birth, the weight of the baby generally comes down but resumes subsequently so you need not worry about that. I hope that helps. Feel free to revert back in case of further queries if any.