The surgical procedure for normal pressure hydrocephalus includes implantation of the ventricular peritoneal shunt. This procedure does not last longer than an hour and is performed under general anesthesia. The incision lines are done on both, she skull and on the abdomen since the goal of the operation is to drain the cerebrospinal fluid from the brain ventricle into the peritoneum.
It is essential that the patients are monitored within 24 hours after the surgery for possible neurological complications. Some surgeons believe it is good if the patients are lying flat in the bed since this position can make the subdural air to dissipate completely. The postoperative incisions are carefully bandaged and monitored for possible infections. In some cases physical therapy is needed. This therapy will help the patient to improve motor skills that might have been affected during the surgery.
There are possible complications in spite of the sufficient experience of the surgeons that perform this surgical procedure. Namely, the risks of potential complications are higher in case of normal pressure hydrocephalus comparing to treatment of children with hydrocephalus.
The complications can occur during the operation or in postoperative period. Some of the complications include the infection of the wounds, postoperative meningitis and intracranial bleeding. Even seizures can be one of the possible complications. Fortunately, all the mentioned problems can be easily treated and further damaged prevented.
On the other hand, there are certain complications that can occur months or years after the surgery. The most frequent of these complications is shunt obstruction. Sometimes obstruction can repeat. Nonetheless this problem is no cause for worry as it can be dealt with rather successfully.
Definitely the most serious of all complications is subdural hematoma. It carries a lot of risk of additional problems and is threatening for patient's life.
Outcome and Recovery
The surgery for normal pressure hydrocephalus is highly successful. Certain symptoms such as moderate dementia or problems with bladder can get better within the days after the surgical procedure. In some patients these symptoms require certain period of time to abate. Still the improvement is most obvious within a week after the surgery.
Patients who have undergone shunt surgery can continue with their daily activities. They are, on the other hand, forbidden to be under excessive physical strain. The regular chek-ups are also significant.
In some cases a surgeon has to perform a revision of the shunt. This procedure modifies or replaces a shunt system. It is usually performed in case certain complications occur.