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Suggest Treatment For Headaches Caused After An Endoscopic Third Ventriculostomy

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Posted on Wed, 3 Dec 2014
Twitter Wed, 3 Dec 2014 Answered on
Twitter Tue, 30 Dec 2014 Last reviewed on
Question : Recently, I had an ETV in NY by a neurosurgeon recommended by my neurologist. The procedure did not work. So, in consultation with the NY neurosurgeon and a neurosurgeon in MD, the MD neurosurgeon in MD uncapped the but was required to put in a new shunt system was put in. After surgery, the neurosurgeon set the shunt at .50. Yesterday, my neurologist told my that my ventricles had collapsed and he raised the setting from .50 to 1.0. I know that it will take a few days to take effect. Is there anything else I can do. As a background, I have had a shunt since I was 5 weeks old and I am now 36. I have received all of my revisions at Children's Hospital in XXXXXXX D.C., & Johns XXXXXXX I have been with this Neurologist for about 13 years and I am very satisfied with him as he is extremely knowledgeable, well known and tops in his field. However, do you have any suggestions as I have been unable to get rid of the headaches that run anywhere from 7-10 on a scale of 10. Please email me at YYYY@YYYY . Thanks.
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Answered by Dr. Geldon Fejzo (2 hours later)
Brief Answer:
Overdrainage through the shunt causes Intracranial hypotension

Detailed Answer:
Hello. I have through your question and understand your concern.

By now I suppose you have been informed on the CSF and how shunts and ETV work. Since your ETV failed the shunt are indispensable for draining the CSF. The cause of your headache is the overdrainage of CSF causing intracranial hypotension. Since you fixed the pressure of the valve of the shunt system, it will just take a few days for your headache to go away. But I would also recommend some measures for intracranial hypotension (ICH).
The headache of ICH typically resolves with conservative management and bed rest. It is believed that the supine (lying down) position reduces CSF pressure. Intravenous or oral caffeine and theophylline have been reported to be dramatically effective in 75% of cases of ICH.

Hope these answers your question, please feel free to use healthcaremagic again.

Wish you the very best health.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Geldon Fejzo

Neurologist, Surgical

Practicing since :2009

Answered : 337 Questions

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Suggest Treatment For Headaches Caused After An Endoscopic Third Ventriculostomy

Brief Answer: Overdrainage through the shunt causes Intracranial hypotension Detailed Answer: Hello. I have through your question and understand your concern. By now I suppose you have been informed on the CSF and how shunts and ETV work. Since your ETV failed the shunt are indispensable for draining the CSF. The cause of your headache is the overdrainage of CSF causing intracranial hypotension. Since you fixed the pressure of the valve of the shunt system, it will just take a few days for your headache to go away. But I would also recommend some measures for intracranial hypotension (ICH). The headache of ICH typically resolves with conservative management and bed rest. It is believed that the supine (lying down) position reduces CSF pressure. Intravenous or oral caffeine and theophylline have been reported to be dramatically effective in 75% of cases of ICH. Hope these answers your question, please feel free to use healthcaremagic again. Wish you the very best health.