Hydrocephalus is characterized by the accumulation of cerebrospinal fluid in the brain. As a result, intracranial pressure increases, and there is physical pressure from the hypertrophied ventricles on various areas of the brain, which can lead to coordination disorders, neurological impairments, and cognitive dysfunction.
Israeli specialists have gained significant experience in treating this condition using modern brain shunting technologies and endoscopic surgeries. Thanks to the use of the latest techniques, our neurosurgeons are able to successfully treat hydrocephalus of almost any type – acquired and congenital, obstructive and absorptive, internal and external, manifesting in both acute and chronic forms.
Hydrocephalus – Modern and Effective Treatment Methods Used in Israel
There are several classifications of hydrocephalus depending on the physiological features of cerebrospinal fluid drainage disruption, the nature of the disease, and its course. Most commonly, congenital and acquired hydrocephalus are distinguished.
Congenital hydrocephalus is found in children who are born with impaired circulation of cerebrospinal fluid. This condition arises due to infections contracted by the mother during pregnancy (certain types of influenza, rubella, cytomegalovirus), spinal developmental defects, or genetic disorders. Statistically, one in a thousand children is born with a defect such as spina bifida. Most of these children have congenital hydrocephalus. Congenital hydrocephalus leads to serious impairments in brain and central nervous system functions – speech, learning, memory, vision, movement coordination disorders, and the development of epilepsy.
Acquired hydrocephalus occurs in both children and adults. It can arise due to head injuries, the development of brain tumors, or infectious diseases (meningitis, etc.).
Treatment of hydrocephalus involves surgical methods that restore normal cerebrospinal fluid circulation and normalize intracranial pressure. There are two such methods – brain shunting and endoscopic ventriculostomy.
Shunting involves the implantation of a tube that drains fluid from the brain's ventricle into the abdominal cavity. The shunt is equipped with a pump that regulates fluid pressure. The shunting operation is performed by a neurosurgeon. The procedure is done under general anesthesia and takes about 2 hours. After shunting, the patient remains in the hospital for several days.
Disadvantages of the shunting operation include the need for repeated shunt revisions, the risk of blockage, and infection leading to subsequent brain infection.
Endoscopic ventriculostomy represents a more modern form of hydrocephalus treatment and is used in the vast majority of cases. During the operation, the neurosurgeon creates an opening in the floor of the brain's ventricle, allowing cerebrospinal fluid to flow into the brain's cisterns and be absorbed into the bloodstream naturally. Indications for this operation include obstructive hydrocephalus – a type of hydrocephalus that occurs due to disruption of the natural pathways for cerebrospinal fluid drainage.
The operation is also performed under general anesthesia and takes about 1 hour. The surgeon makes a small opening in the patient's skull through which an endoscope is inserted. Observing the procedure through a miniature camera on the endoscope, the neurosurgeon perforates the floor of the third ventricle. The endoscope is then removed, and the opening in the skull is closed.
Compared to shunting, endoscopic ventriculostomy has several advantages – it carries a lower risk of complications and is better tolerated. In some cases, ventriculostomy is performed when a previously installed shunt is blocked (with simultaneous removal of the shunting system).
An operation performed early in the disease's development can completely alleviate hydrocephalus symptoms, normalize fluid pressure in the brain, and restore natural cerebrospinal fluid circulation. Children who undergo ventriculostomy in a timely manner develop normally and lead a regular life, often with no restrictions.
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Diagnosis of Hydrocephalus at Ichilov (Sourasky) Clinic
Currently, there is an unnatural situation regarding the diagnosis of hydrocephalus in children at clinics in the former CIS countries. Lacking the ability to use precise diagnostic equipment, pediatric neurologists diagnose "hydrocephalic syndrome" at the slightest deviation from normal parameters. Often, victims of excessive diagnosis are children who do not require any treatment – neither medical nor surgical.
Doctors at our clinic have all the necessary equipment to either accurately diagnose the disease or refute a previously made diagnosis. The most modern tomographic equipment is used for this purpose. The process of diagnosing hydrocephalus at Ichilov (Sourasky) proceeds as follows.
First Day – Arrival in the Country
Upon arrival at Tel Aviv airport, the patient (or young patient accompanied by parents) is met by a clinic representative – a curator. The curator organizes the diagnosis and treatment and also acts as a translator. Together with the curator, the patient goes to the clinic for the first consultation with the leading specialist. The doctor reviews the medical history and orders a series of tests.
Second Day – Diagnosis of the Disease
During the second day in the country, the patient undergoes a complete diagnostic workup, which includes various types of studies.
- Magnetic resonance imaging is one of the most accurate diagnostic methods and allows visualization of anatomical changes in the brain's ventricles. MRI with contrast is also used to measure the rate of cerebrospinal fluid drainage.
- Magnetic resonance spectroscopy allows for a more detailed study of brain abnormalities, identifying characteristic metabolites, and in some cases helps differentiate hydrocephalus from other diseases – Alzheimer's disease, Parkinson's disease, etc.
- Measurement of intracranial pressure allows for determining the severity of the disease.
- Lumbar puncture is a minimally invasive procedure that involves taking a sample of cerebrospinal fluid and measuring the pressure of the fluid in the spinal canal. Additionally, the puncture slightly reduces intracranial pressure, leading to temporary relief of hydrocephalus symptoms.
Third Day – Treatment Program
On the third day, the leading specialist analyzes the results of the conducted studies, establishes a final diagnosis, and plans the treatment program. In our clinic, the decision regarding the most appropriate type of surgical treatment is made collegially – the medical council includes not only the leading specialist but also other doctors. The patient has the right to seek a “second opinion” – an independent opinion from a third specialist regarding the established diagnosis and chosen treatment method.
Treatment of Hydrocephalus in Israel – Prices
One of the reasons many patients prefer to undergo treatment for hydrocephalus in Israel is the cost of surgeries. Although both shunting and endoscopic ventriculostomy, like any other neurosurgical interventions, are quite expensive, the cost of such operations in Israeli clinics is 30-50% lower than in medical centers in the USA or the European Union.
Advantages of Hydrocephalus Treatment at Ichilov (Sourasky) Center
- Neurosurgeons with extensive experience. All neurosurgeons at our clinic have 10-15 years of experience and have accumulated unique expertise in treating hydrocephalus.
- For performing surgeries – both open and endoscopic – the neurosurgery department at Ichilov (Sourasky) uses only the most modern equipment, significantly reducing the risk of postoperative complications.
- Treatment of hydrocephalus in children in Israel is conducted using gentle techniques, primarily endoscopic. As a result, young patients recover their strength more quickly and have the opportunity to develop normally, just like their healthy peers. Hydrocephalus in adults in Israel is also treated using endoscopic technologies.
- The international department of our clinic ensures that patients arriving for treatment from other countries feel comfortable and receive necessary medical and diagnostic procedures in a timely manner.
- A patient admitted for treatment receives an individual curator-translator responsible for interaction with doctors and organizing all prescribed medical procedures.
The neurosurgeons at Ichilov (Sourasky) Medical Center are experienced professionals whose expertise, knowledge, and commitment to helping people have allowed many patients with hydrocephalus to forget about their condition forever.