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Q. A patient has hydrocephalus associated with many other problems. Kindly advice.

Answered by
Dr. Aida Abaz Quka
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Jun 28, 2019

Hello doctor,

I am an occupational therapist, and my client's mother would not let me talk to her neurologist even though I need to script some equipment. So I wanted to ask general questions, the client is 12 years old and has hydrocephalus and had many many surgeries as her shunts keep becoming blocked. She now has the most significant possible VP shunt in her brain, and recently (a couple of weeks ago) had a bleed after surgery, but that has been treated now, and she is going well.

The client also has uncontrollable absence seizures, a chromosomal disorder, intellectual disability, connective tissue issues, hand deformity, and recently diagnosed tuberous sclerosis (skin and possibly in the brain). The client's mother would like me to complete a funding application for them to get a hospital bed at home, as the daughter (client) is currently sleeping upright with pillows.

She said sleeping upright helps the shunt drain. I have not been able to find any research around this, and have also read about something that says over drainage can be an issue. Did you have any thoughts about this issue? Or if it is really client specific and I do need to contact her neurologist or neurosurgeon.

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Hello,

Welcome to icliniq.com.

I read your question carefully and would explain the upright position (head of the bed 45 degrees) can help reduce the intracranial pressure. So, I agree with the patient that she feels better in this position. Regarding the medication, I would recommend Diamox and Furosemide to help reduce intracranial pressure. An anti-epilepsy drug is also needed for her seizures. I would suggest Valproate or Levetiracetam. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need.


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