Dr. Josue Diaz Ordaz, MD

Hydrocephalus is most often treated with an implanted device called a shunt. A shunt is a long, thin tube that is used to drain excess fluid. One end is placed within the brain. The tube runs under the skin, along the neck behind the ear, and to another part of the body where the fluid can be reabsorbed. Most often this is the abdomen, but the chest or other areas can also be used. Shunts have a valve that allows doctors to monitor and control the pressure within the brain. Insertion of a shunt is a surgical procedure that takes one to two hours. Incisions are made in the head and the abdomen, and the shunt is threaded into place before the openings are stitched closed.

In cases where hydrocephalus is caused by a blockage, a procedure called endoscopic third ventriculostomy, or ETV, may be performed. During this procedure, a surgeon makes a dime-sized hole in the skull and uses a thin tube with a camera on the end (called an endoscope) to see inside the brain. The surgeon punctures a hole in the floor of the third ventricle, a fluid-filled space within the brain. The hole provides an opening for cerebrospinal fluid to flow around the blockage, normalizing pressure. The entire procedure usually takes less than an hour and patients can often go home the following day. ETV can provide a permanent and safe alternative to a shunt, but it is only useful for patients whose hydrocephalus is caused by a blockage.

Occasionally, the SI joint can become irritated, painful, or arthritic. Problems with the sacroiliac joint can be caused by trauma, infection, or other issues. The main symptom of SI joint damage is pain in the lower back, hips, and thighs. This pain may become worse when rising from a sitting position. When non-surgical treatments such as medications and physical therapy are not effective at relieving pain, surgery may be considered as an option.

During SI joint fusion, a small incision is made on the side of the buttock near the hip. The surgeon removes the cartilage, a firm, smooth substance between the bones. Then the joint is fused by the placement of rods, screws, or plates that hold the sacrum and the pelvis together. This reinforces the joint, stabilizing the pelvis and helping to support the upper body. Patients may be able to stand and walk the very next day after surgery but will need crutches to get around for the first few weeks. Full recovery and return to normal activities takes up to a year as the tissue around the joint grows and heals.