This fluid, called cerebrospinal fluid, or CSF, acts as a shock absorber for the brain and spine. It also carries nutrients to the brain and waste away from it. The adult brain makes about a pint of CSF every day, which is then gradually absorbed back into the body.
For reasons that are not fully understood, as some people age, their brains are not as good at handling the daily production and recycling of CSF. As a result, the ventricles, which are the CSF-filled spaces in the middle of their brain, enlarge. These enlarged ventricles crowd out other parts of the brain and can cause symptoms such as poor balance, memory problems and urinary incontinence.
This is a condition called normal pressure hydrocephalus, sometimes known as “water on the brain.” When it occurs in people over age 65 (adult hydrocephalus) it can be tricky to diagnose, as the symptoms are similar to the normal signs of aging. In fact, ventricles can enlarge as a normal part of aging, or as a part of degenerative diseases like Alzheimer disease.
For the last several years Dr. Guy McKhann, Director of the Adult Hydrocephalus Center, has moderated a panel on this elusive condition at the yearly meeting of the American Association of Neurological Surgeons (AANS). The team at the Columbia Adult Hydrocephalus Center is one of the most experienced in the world at diagnosing and treating this condition.
Dr. McKhann once again moderated this popular panel at the latest meeting, leading discussions on how to diagnose, evaluate and treat adult hydrocephalus. The panel also discussed the pros and cons of different types of treatment: shunt surgery versus endoscopic third ventriculostomy (ETV).
Shunt surgery involves placing a tube, called a shunt, into the brain to drain the CSF out of the head. This CSF is directed into the abdominal cavity, the area that contains the stomach, liver and intestines. Here the CSF is absorbed back into the body.
ETV involves making a small hole in one of the ventricles of the brain, allowing the fluid to drain into a different part of the brain, which will then allow the fluid to flow normally.
Learn more about adult hydrocephalus here.
Learn more about Columbia Neurosurgeons and the Department of Neurosurgery at Columbia here.
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