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takyon [soylentnews.org] writes:

Surgery For Saving Babies From 'Water On The Brain' Developed in Uganda [npr.org]

Traditionally doctors treat hydrocelphalus in the U.S. with what's called a shunt: They place a long tube in the baby's brain, which allows the liquid to drain into the child's stomach. But a third of the time, these shunts fail within two years, says Dr. Jay Riva-Cambrin, a neurosurgeon at the University of Calgary. "Imagine buying a car and having the dealer tell you, 'By the way, there's a 40 percent chance the car won't be on the road in two years.' You'd be like 'No way.' "

That failure rate is tolerable here in the U.S. because children can be rushed quickly to a hospital for emergency surgery to fix the shunt, says Dr. Benjamin Warf, a neurosurgeon at Harvard Medical School, who led the development of the new method at a clinic in Mbale, Uganda. "Some kids wind up having dozens of these shunt operations over over the years," he says. But for many kids in rural Uganda — and other poor countries — emergency neurosurgery isn't an option. "They're going to die from a shunt malfunction," Warf says. "I can't put a shunt in a baby and then send them back to a rural village in western Uganda or southern Sudan because it would take days to return to the clinic."

So Warf and his colleagues decided to innovate. They took a technique that works in adults and then tweaked it a bit so that it would have a better chance of working with babies. In the new method, doctors basically poke a hole in the brain's chambers so they can drain. They also prevented the chambers from filling back up by partially damaging the region of the brain that produces spinal fluid.

The team knew the procedure fixed the hydrocephalus. They could see that the babies' brains stopped swelling. But the big question was whether or not the method could prevent brain damage as effectively as shunting does. After 15 years of testing and optimizing, he and his team can finally say that their approach — at least in the short term — appears to be just as effective as the procedure commonly used here in the U.S. In the study, Warf and his colleagues tested the two methods on about 100 children in Uganda. After 12 months, the doctors couldn't detect a difference in the children's brain volume or cognitive skills.

Hydrocephalus [wikipedia.org].

Endoscopic Treatment versus Shunting for Infant Hydrocephalus in Uganda [nejm.org] (open, DOI: 10.1056/NEJMoa1707568) (DX [doi.org])

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