Hydrocephalus post op 2nd surgery

[mk]

I have been in contact with a forum member who had her second surgery on March 20th (following a first debulking surgery and GK). She was doing well initially, the tumor was mostly removed, but she has developed hydrocephalus. Her doctors seem puzzled; there is no evidence of infection, protein in the CSF, swelling or blockage. However the ventricles are dilated, and she has clear symptoms of hydrocephalus. She is currently on steroids, while the doctors are assessing her situation. Obviously they are considering a shunt. She has been through so much, and would like to avoid this if possible.
I remember a lot of past discussions about hydrocephalus, however I don't recall anyone with this problem post-op. Has anyone experienced this, or heard about hydrocephalus post-op? Can it resolve spontaneously? How did the doctors deal with it?
Also, for those who have a shunt, did you experience any problems? She was told that the shunt operation right after surgery can carry risks of even more complications.

Any input is appreciated, and I will pass on the answers to her.

Thank you,
Marianna

[PaulW]

I have read about Hydrocephalus post radiation even for small tumours.
Think how sunburn causes blisters... Apparently any cell damage can cause hydrocephalus.
It can be a protective over reaction to the damaged tissue
I gather though that the protein test would check for the above though.
Likewise infection can cause hydrocephalus.
I see why the doctors would be puzzled, if there is no infection or proteins in the CSF.

If the pressure becomes to high a shunt is the only solution.

[PaulW]

Paper on Hydrocephalus and Gamma Knife

Looks like protein not always present in CSF.
Average volume was 6509mm2 which is about 2.5cm
http://www.ncbi.nlm.nih.gov/pubmed/22535199

[mk]

Thank you Paul,

this was my understanding to about the causes for hydrocephalus.

Michaela's doctors are now speculating that there may have been some blood during the surgery, which caused blockage. But no definitive answers (or actions) yet.
Is there a way to monitor intercranial pressure, to make sure that it doesn't rise above certain limits?

Marianna

[Alison]

Hi, interesting.
can anyone tell me what are the actual symptoms of hydrocephalus after SRS? At my first apt with oncology doc before treatment she said I "may already have hydrocephalus" then looked at the MRI and said I didn't. So does that mean you can have it with just bad imbalance diizziness and ear pressure as symptoms? They were mine and are still, but much worse now, post treatment,  3.5 months after SRS (Linac in UK).

The list of sypmtoms for hydro when you google it lists things such as incontinence, visual disturbances, muscle weakness, vomiting etc. Can you unwittingly have it without these ? Hence the doc saying what she did at first apt?

It's ease my mind to have some clarity on this if possible!

Many thanks, Alison

[Alison]

Hi Marianna again, forgot to say, hope Michaela is improving and they can find an answer.

Best wishes, Alison

[Crazycat]

I've been around the block with hydrocephalus. I had to have a shunt installed before the tumor resection/debulking.

The symptoms for me were extreme equilibrium problems. Before my surgery I was walking around with convex vision and my head felt like a lead-filled helium balloon (if that makes any sense). I could not walk on uneven surfaces without staggering like a drunk. If I moved or turned too suddenly I'd fall over. The fatigue was the worst.

I went in the hospital for the shunt install one month before the AN resection. Dr. Barker told me that I'd be feeling a lot better after the fluid pressure on my brain had been reduced—and he was right! I could feel the difference as my gait had improved
dramatically though I was not out-of-the-woods yet. The real test came a month later with the main event surgery.

I had waited way too long to be diagnosed and treated. That thing grew to the size of a golf ball.  I'm still amazed I came through it as well as I did.

[Alison]

Hi, thanks for the info crazycat and sorry to hear of your problems. Your symptoms (apart from the vision as yet) match mine completely. I have rung my oncology doc, who wasn't available (surprise surprise) but have asked firmly for her to ring me back and to say I want an MRI to see what's going on. Here in the UK it's a bit more difficult to get a response from the docs!

I'll post again,

Thanks

Alison

[Alison]

 Hi everyone,

I have posted "post MRI" as promised, so that anyone with the same concerns post SRS can follow the outcome.

I have collected the brief report sent by the radiologist to my GP (GP can't access images). Good news so far as no signs of hydrocephalus (phew! horay!) but there are signs of swelling in the part of the AN in the CPA. Unfortunately the report does not give measurements for me to know how much the AN has swelled by. The swelling prob explains my much increased vertigo and imbalance, so hoping it doesn't swell too much more. I'm only 4 months post SRS so potential for more I suppose.

Thanks Alison x