I have been diagnosed a few years ago with water on the brain but was told it was best not to insert a shunt as it was monitored by mri every 6 months for over 2 yrs with no change but my memory has been getting worse lately and some other  symptoms so thinking of getting a shunt inserted , i live in chiangmai & was hoping to get info from people who have had this done in chiangmai or even bkk & a ball park figure for prices and anything else i should know about etc

 

Cheers

The first thing you need to know is that the fact that you have some mild hydrocephalus ("water on the brain" - all brains are bathed in water, but in some cases the water does not circulate as it should and there is some build up) - and that your memory is getting worse etc does not necessarily mean the one is the cause of the other.

 

Often the two are unrelated and the mild hydrocephalus is an incidental finding. Quite a lot of older people have what is called "normal pressure hydrocephalus" (NPH) and are completely asymptomatic with it.

 

In addition, shunts carry significant risks and the risk-benefit ration varies by individual. ,(Among other things shunts can become infected, leading to meningitis or encephalitis. Brain hemorrhage is another complication.)  In addition, some people are more likely to respond to a shunt that others. MRI studies which analyze the flow of the cerebrospinal fluid can help predict this. Whether to perform a shunt on any given patient is a complex decision and what applies to one person may not to another.

 

So you need to start with a careful neurological assessment to determine if the hydrocephalus is likely to be a cause of the memory issues and other symptoms. IF it is, then your risk factors need to be assessed and weighed against the potential  benefits.

 

See http://www.hydroassoc.org/docs/INPH Guidelines/Surgical Management of INPH.pdf

 

While there are doctors at CMU Hospital with experience in placing shunts, AFAIK they have doen so only for patients with hydrocephalus and increased intracranial pressure, which is an automatic indication and not likely your situation. The only doctors I am aware of in Thailand with expertise in this specific to normal pressure hydrocephalus are in Bangkok,  at Siriraj.

 

Given the complexity and risks it would be worth flying down there.

 

Doctors:

 

Prof. Theerapol Witthiwej

Prof. Pathomlirk Sathira-ankul

http://www.siphhospital.com/th/splash

Thanks for your quick & comprehensive response ,the last time i saw the specialist he said just to keep monitoring it & they would only operate if it got worse  , well my short term memory is now terrible its like i go upstairs then forget what i went there for almost like dementia but im 45 not 75 & its affecting my work life also so if a shunt will help i have to consider it , the specialist i saw was at cm ram

Again, urge you to go to Siriraj in Bkk