How Our Program Works

Normal Pressure Hydrocephalus Program

How Our Program Works

Here at the Monmouth Neuroscience Center we have developed a multidisciplinary hydrocephalus assessment program to evaluate patients with suspected NPH and determine who is most likely to benefit from a shunting procedure.

Patients are admitted to the intensive care unit, where a sterile lumbar drain can be placed to continuously drain CSF over 1-3 days, while they are carefully evaluated by our multidisciplinary team of neurologists, neurosurgeons and physical therapists for improvement in memory and gait using objective measures including videotaped gait analysis.

At the conclusion of the procedure, the drain is removed, and patients can review this data with their doctors to decide whether they might benefit from elective re-admission for placement of a permanent ventriculoperitoneal shunt.

The shunt is implanted under general anesthesia in a procedure that takes about an hour. A small hole is made in the skull, and the membranes between the skull and brain are opened. The brain end of the shunt is gently passed through the brain into the lateral ventricle. The valve and abdominal (peritoneal) end is passed under the skin and then implanted into the abdominal cavity through a small abdominal incision.

Our program doesn’t end with the surgery! Our surgeons will usually have implanted a shunt with magnetically programmable valve which allows easy access to fine tune shunt function over time. Patients are regularly followed by our team of neurologists and neurosurgeons, with ongoing adjustment of the valve in the shunt using an external programming device to ensure the correct rate of CSF drainage, to maximize neurologic improvement and minimize complications.

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