HYDROCEPHALUS
Congenital Hydrocephalus is the result of a malformation that hinders the drainage of cerebro-spinal fluid (the fluid which covers the brain and spine). As the fluid cannot drain, it collects inside the skull, causing unlimited enlargement of the head and brain damage. Untreated it will cause grotesque enlargement of the head and severe mental retardation. The first artificial drainage systems, shunts, were created in the 1950’es. This is essential a tube with a valve which drains the fluid from the skull into the abdominal cavity, where the fluid is absorbed. Later years shunt surgery has been become accessible in Addis Abeba, but our impoverished patients could never afford the astronomic surgical fees, not to mention the cost of transport and living in the big city.
Shunt surgery is performed in Aira hospital with a very cheap and simple technique. As we cannot afford to buy commercial available shunts, an intravenous plastic line with cut holes in the ends is used to connect the inside of the skull with the abdominal cavity. The tube drains the fluid from the high pressure in the skull into the low pressure in the abdomen, where the fluid is absorbed.
|
|
|
|
|
Hydrocephalus patient on the operating table |
Hockey shaped incision in the scalp |
Small hole drilled in the cranial bone |
|
|
|
|
|
Hole with underlying dura (brain covering) |
Incision made in the abdomen |
Metal rod with sharp end covered by a plastic tube ….. |
|
|
|
|
|
…is used to make a tunnel under the skin from head to abdomen |
Intravenous line with holes cut in the ends |
The plastic line is introduced into the lateral ventricle of the brain with the aid of a pin |
|
|
|
|
|
Plastic line inside the fluid-collecting system of the brain |
Plastic line inserted in the abdominal cavity |
Surgical procedure completed |
Unfortunately the parents do not understand the importance of follow up and/or cannot afford the expenses connected with transport and OPD fees, so very few patients are returned for check-up. Now and then we meet one of the patients in the OPD or in the ward admitted for some other disease.
One patient has come quite regular since his surgery 2004
|
|
|
|
May 2004 - Before surgery |
May 2004 - Before surgery |
|
|
|
|
August 2006 |
May 2008 |
