Normal Pressure Hydrocecephalus, Chiari Malformation and Other Brain Conditions

Hydrocephalus and Chiari malformation treatment.A variety of brain conditions don’t fall into the tumor category or cerebrovascular disease category. At NeurosurgeryOne, we treat many brain conditions including normal pressure hydrocephalus, Chiari malformation type 1, pseudotumor cerebri, epilepsy, Parkinson’s disease, and trigeminal neuralgia.

 

Normal pressure hydrocephalus treatment 

Normal pressure hydrocephalus (NPH) occurs when cerebrospinal fluid (CSF) in the brain accumulates abnormally. CSF flow can become impeded due to a blockage, which leads to swelling of the ventricles that put pressure on the brain.

Elderly people are most commonly diagnosed with NPH, although anyone can develop the condition. NPH can occur spontaneously or when bleeding in the brain results from head trauma, tumors, a subarachnoid or intraventricular hemorrhage, or a complication of surgery. Symptoms of NPH include lack of bladder control, walking limitations, and progressive mental impairment and dementia.  

Surgery is most commonly recommended for NPH. NPH surgery involves placing a shunt in the brain to drain the excess cerebrospinal fluid (CSF), which relieves the symptoms.

 

Chiari malformation type 1 treatment

Chiari malformation type 1 occurs when a part of the brain—the cerebellum—protrudes through the opening at the base of the skull. While it is most commonly a congenital issue, Chiari malformation type 1 is not typically detected until adolescence or adulthood. Chiari malformation type 1 also can be acquired and develop after birth as a result of infection or injury.

Many patients with Chiari malformation type 1 have no symptoms. Others, however, exhibit symptoms due to the development of a syrinx, which is a fluid filled cavity either in the brain stem (syringobulbia) or spinal cord (known as a syringomyelia). Symptoms vary greatly and may include neck and head pain, dizziness, loss of arm or hand strength, sleep apnea, or double or blurred vision.

For patients without symptoms, monitoring is typically the recommended treatment. For patients with symptoms, surgery may be recommended. Decompression surgery is the most common type of surgery for Chiari malformation type 1. At NeurosurgeryOne in Denver, our neurosurgeons remove a tiny piece of the occipital bone, which is located in the lower back portion of the skull. This is known as a craniectomy, which is removing part of the skull to relieve pressure. After the portion of the skull is removed, the dura—the outer membrane of the spinal cord and brain—is cut and made larger to allow for more space for the brain.

 

Pseudotumor cerebri treatment

Pseudotumor cerebri results when intracranial pressure, which is pressure around the brain, increases for no known reason. Also referred to as idiopathic intracranial hypertension, pseudotumor cerebri symptoms are similar to those of a brain tumor. Patients can experience vision loss as pressure around the optic nerve increases. This disorder more commonly affects women ages 20-50 and people who are obese.

Regular ophthalmologic exams are recommended to monitor changes in vision. Changes in diet and lifestyle to lose weight as well as discontinuation of certain medications may be recommended. In cases where pressure cannot be relieved, surgery to place a shunt to drain excess cerebrospinal fluid (CSF) from around the optic nerve may be recommended.