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Very cool. My daughter has a brain shunt due to complications of spina bifida and so we’re thinking of cerebrospinal fluid on a regular basis. As a layman I gue
by wincy 5y ago
Very cool. My daughter has a brain shunt due to complications of spina bifida and so we’re thinking of cerebrospinal fluid on a regular basis. As a layman I guess there’s a particular cerebrospinal fluid pressure you want, and that being too high or too low causes issues? Apparently the shunt just drains into her belly so I also found that interesting. Too high and she’ll have terrible headaches and an “alien” head (sorry, don’t mean offense by that but it’s what I’m trying to avoid for my child) and I don’t know what would happen with too little, maybe someone could tell me. Probably not good I’m assuming.
I frequent some FB groups for parents of children with SB and am shocked at how large some people let their kids heads get without consulting with or complaining to a doctor.
- asia92 5y agowhat exactly do you mean by alien head? not offended, just curious
- sezna 5y agoa physically large head, shaped similarly to a stereotypical alien head
- turnerc 5y agoI believe they mean enlarging of the fontanelle as is typical in those with hydrocephalus.
- airstrike 5y agoYou can google "hydrocephalus", though I should warn the images can be a bit disturbing
- 1-6 5y agoAt least in the US, early intervention allows doctors to recommend shunts so extreme cases of hydrocephalus can be avoided and head sizes normalize a bit as kids grow. The photos are usually from med textbooks and for teaching future doctors and usually demonstrating the extreme forms. Let’s not say alien head. My biggest worry as a young dad was my child being called names because of his head circumference. He too was born with HC.
- airstrike 5y ago> Let’s not say alien head. To be clear, I never said that and agree the term shouldn't be used at all.
- wincy 5y agoI can’t post the specific child’s picture as it wasn’t posted publicly and I wouldn’t want to disrespect them, but here’s some examples of less severe hydrocephalus you’ll see often in spina bifida parenting groups [0] [1]. Often people don’t comment on ones like that as everyone wants to get along but if it’s left untreated it can eventually progress to be much more severe and cause debilitating headaches and mental retardation. Interestingly, in googling this apparently low pressure cerebrospinal fluid headaches are also a thing [2], so keeping just the right amount of cerebrospinal fluid draining is a must. [0] https://www.hydroassoc.org/people-view/wylie-6-months/ https://www.hydroassoc.org/people-view/wylie-6-months/ [1] https://www.travelblog.org/Photos/253290 https://www.travelblog.org/Photos/253290 [2] https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/low-csf-headache https://www.hopkinsmedicine.org/health/conditions-and-diseas...
- chriscross 5y agoToo little CSF leads to the brain crushing itself under gravity. The brain is almost entirely lipids which contributes to its buoyancy in CSF. Take away too much CSF, nothing for it to float in. Too much CSF? The skull is a fixed volume (in adults) so the CSF compresses the brain tissue. In kids, the sutures or junctions between bones of the skull are still flexible. This allows for childbirth and normal rapid brain growth. It’s easy to tell if there too much fluid around the brain in a newborn because their front soft spot (Fontanelle) will bulge or become firm. A bulging fontanelle also occurs with other pathologies like meningitis.
- dhmallon 5y agoIf there is too little CSF (e.g. a CSF leak), the brain 'slumps' but it doesn't "crush itself under gravity". Too much CSF can lead to hydrocephalus, which is enlargement of the ventricles. I wouldn't describe it as CSF "compressing" the brain tissue.
- treeman79 5y agoHad a spinal leak after a spinal tap. So too little fluid. It’s a very unique pain. Severe pain at top of head unless laying flat. I spent an entire week laying flat on a couch with a happy cat sitting on my chest. Initial treatment was an IV of caffeine. Then they they had to patch the hole.
- bobowzki 5y agoI think it drains into the peritoneum but I'm not completely sure. There's a resistance on the shunt to maintain pressure. Too high will cause hydrocephalus with all sorts of complications. Too low will cause a massive headache short term, long term I'm not sure. I'm an anesthesiologist and frequently work with neurosurgeons.
- jac241 5y agoThey tunnel it in the subq until the abdomen then they make a tiny incision in the peritoneum and depending on the neurosurgeon may have general surgery take a look laparoscopically to make sure there’s CSF flow then use the grasper to try to toss it in the right pericolic gutter over the liver.
- sizzle 5y agoHow do they avoid bacteria from going up a shunt to the brain?
- serf 5y agoI thought that was an interesting question as a layman. I found this, which I thought was an interesting read. [0] [0]: https://www.sciencedirect.com/topics/medicine-and-dentistry/shunt-infection https://www.sciencedirect.com/topics/medicine-and-dentistry/...
- jac241 5y agoYeah sterile technique has to be meticulous in shunt cases. There’s evidence that the number of people scrubbed into the case influences the shunt infection rate so students like me occasionally would not be permitted to scrub.
- jac241 5y agoThere’s generally no bacteria outside of the food tube though it certainly could happen the way you describe if there happened to be.
- mensetmanusman 5y agoThe technical founder of this company is developing wireless monitors for this cerebrospinal fluid pressure: https://www.rhaeos.com/ https://www.rhaeos.com/ We got to hear him speak pre-pandemic, definitely cool tech.
- zaptrem 5y agoI know someone who could benefit significantly from this. How would he go about acquiring one?
- tsoukase 5y agoToo little CSF leads to slit ventricle syndrome with a scary clinical image but not life threatening. Direct consequence is bilateral subdural hygromas.
- graderjs 5y agoI'm not a doctor and don't at all want to pretend to presume I can understand for sure what would or wouldn't be helpful. And I'm not assuming you need help--but I just thought something I know might be helpful somehow for your daughter and you. Certain type of yoga breathing exercises (pranayama), as a result of involving contracting muscles in the body while breathing, help to pump CS fluid through its "ventricles", as well as to move lymph around. I have no idea how a shunt works, or would interact with these exercises, but as a result of the shunt intervention I'm worried these exercises may be dangerous to your daughter. At the same time, I consider they may also be helpful, by perhaps helping to regulate pressures, or assist training the body to improve its ability to do so, or encourage circulation of the CSF and lymph. Stuff like this might be something useful to explore for you. Have a good day!