MIETHKE GAV, Руководство для пациентов

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13
PATIENT HANDBOOK
GB
CLINICAL SYMPTOMS OF THE CONDITION
In infants, the cranial bones have not adhered so-
lidly yet. The increasing volume of cerebrospinal
fluid causes the head to increase in circumference
while, at the same time, brain tissue disintegrates.
From the age of about 2, the hardened skull pre-
vents any growth of the head‘s circumference. In
that situation, the increase in fluid volume leads to
a massive pressure rise, resulting in the expansion
of the brain ventricles and the compression of the
brain itself. The consequence for infants and adults
can be irreversible brain damage. Symptoms (de-
pending on the severity of the disorder) include
nausea, headache, vomiting, impaired coordinati-
on, drowsiness and, in the end, unconsciousness.
DIAGNOSIS OF THE CONDITION
Doctors have a variety of ways at their disposal
to diagnose hydrocephalus. The ventricle size
is measured through imaging procedures (e.g.
computerized tomography, ultrasound or NMR-
tomography).
Computerized tomography (CT)
This quick and painless diagnostic procedure pro-
duces X-ray images of different layers of the head.
Nuclear Magnetic Resonance (NMR) tomography
This painless electromagnetic imaging process
produces images of very fine layers of the head.
It is also known as NMR, MRT, or MRI scanning.
Ultrasound
This procedure, in which the interior of the head is
examines through the open fontanel, can only be
applied to small children.
Another way of diagnosing hydrocephalus is
through pressure measurements showing an incre-
ased brain pressure. The circulation of cerebrospi-
nal fluid is investigated through examinations with
contrast agents.
METHODS OF TREATMENT
For all the efforts to find therapeutic alternatives to
valve implantation (e. g. through pharmaceutical
treatment or, most recently, by minimally invasive
surgery), there is currently no alternative, in most
cases, to the implantation of a drainage system,
referred to as a shunt.
Fig. 3: Drainage systems for hydrocephalus patients
a) ventriculo-atrial, b) ventriculo-peritoneal
1 right atrium
2 heart catheter (atrial catheter)
3 valve
4 reservoir
5 ventricular catheter
6 ventricles
7 abdominal catheter (peritoneal catheter)
8 abdominal cavity
4
2
1
5
6
3
a)
7
8
4
3
b)
THERAPY COMPLICATIONS
The treatment of hydrocephalus with a shunt sys-
tem can sometimes arise complications. As is the
case for any surgical intervention, there is a risk of
infection. There can also be complications that are
directly or indirectly related to the implanted val-
ve system. Such complications include blockages
of the drainage system or inadvertently increased
fluid drainage. To give you an understanding why
your physician decided for the
GAV , the physics
of drainage is explained in the chapter “Physics
background“.