There are two options to treat hydrocephalus – shunt placement or Endoscopic Third Ventriculostomy (ETV). Neither treatment is full proof and can last a lifetime. Neither treatment makes hydrocephalus go away. It will always be a part of my life.
Because of my age and having obstructive hydrocephalus, I am a prime candidate for an ETV surgery instead of having a shunt put in my body. A dime-sized hole will be made in my skull above my forehead (I always joke near old lobotomy locations). A tiny camera is snaked through my brain until it reaches my third ventricle. Images of my brain are shown on a monitor to help guide the neurosurgeon in making a small hole using a small knife or laser at the bottom of the third ventricle to allow the CSF to drain into a natural re-absorption pathway.
The benefits of having ETV surgery are no tubing and shunt in my body decreasing the chance of infection. There is less incision. Less incisions = less pain. There is also a lower complication rate than a shunt. Shunts often have to be adjusted. The surgery can be anywhere from 30 minutes to one hour. It is estimated that 50% of the shunts fail within the first two years. The success rate of an ETV surgery is 80%
The risk of anything going wrong is approximately 1%. The most common is bleeding and fever. Where they are making is hole is near the hypothalamus so it is possible for short-term endocrine, memory, and diabetes issues. The risk of a sudden ETV closure is 20-50% within five years of surgery. It is not guaranteed that the ventricle size will decrease after intracranial pressure decreases after surgery. Positive outcomes may not be immediately noticeable because the CSF has to naturally drain unlike a shunt placement where success is noticed right away.
I have been told that my physical symptoms will go away and take up to two months to disappear. The mental & cognitive functioning may take a bit longer.
A successful outcome means a shunt-free life, and the only downside is to monitor symptoms in case of a sudden closure. I am confident that the ETV surgery will be problem free and I look forward to being back to my old self and if not my old self; discovering who the new me may be.