Emission Tomography. Like MRI, it’s a technique used to image brain structure and physiology. Our McConnell Brain Imaging Centre is rated as one of the world’s leading facilities.”
“What other research do you do?”
“A tremendous amount of groundbreaking work has emanated from the MNI. The development of electroencephalography, the concept of focal and generalized epilepsies, new methods of frameless stereotactic surgery, contributions to postglandin biochemistry in the nervous system, localization of dystrophin skeletal muscle. I could go on and on.”
I was certain she could. Dr. Russell was obviously proud of her employer. I smiled encouragement, though I understood only part of what she had listed.
She leaned back and laughed. “I’m sure you are not here for a lecture on the Neuro.”
“No, but it’s fascinating. I wish I had more time. But I know you’re very busy and I don’t want to take up any more of your day than necessary.”
I took the container from my purse and handed it to her. She looked at it, then unscrewed the cap and slid the implant onto a piece of paper on the blotter of her desk.
“This is an old one,” she said, turning it over with a pencil. “I don’t think they’ve made this model for years.”
“What is it?”
“It’s a ventriculo-peritoneal shunt. They’re implanted for the treatment of hydrocephalus.”
“Hydrocephalus?” I knew the term, but was surprised to hear her say it. What other misfortunes would I learn about this child?
“It’s commonly known as ‘water on the brain,’ but that’s not really accurate, although that’s a literal translation from the Greek, hydro being water, and cephalus being head. Cerebral spinal fluid is constantly produced in spaces in the brain called ventricles. Normally it circulates through the four ventricles, and flows over the brain’s surface and down the spinal cord. Eventually the CFS is absorbed into the bloodstream, and the amount of fluid and pressure in the ventricles stays within acceptable limits.
“But if drainage is blocked, fluid will accumulate, causing the ventricles to swell and press on the surrounding tissue.”
“So hydrocephalus refers to an imbalance in the amount of CSF produced and the rate at which it drains from the ventricles.”
“Exactly.”
“And, as the CSF builds up, it causes the ventricles to enlarge and the pressure inside the head to increase.”
“You’ve got it. Hydrocephalus can be acquired or congenital, which is not to say hereditary. The term simply means the condition is present at birth.”
“I found the shunt in a normal-looking skull. Doesn’t hydrocephalus result in increased head size?”
“Only in infants, and only if left untreated. As you know, with older children and adults the bones of the skull are already formed.”
“What causes it?”
“There are lots of reasons for inadequate CSF drainage. Prematurity puts an infant at high risk. And most babies with spina bifida have hydrocephalus.”
“Spina bifida involves a neural tube defect?”
“Yes. The problem occurs during the first four weeks of gestation, often before the mother knows she’s pregnant. The embryo’s neural tube, which develops into the brain, spinal cord, and vertebral column, fails to form properly, leading to varying degrees of permanent damage.”
“How common is it?”
“Entirely too common. It’s estimated that spina bifida affects one in every thousand babies born in the United States, and about one in seven hundred and fifty born in Canada.”
“I recovered no vertebrae, so I have no way to know if my young lady had spina bifida.”
Russell nodded in agreement, then continued her explanation.
“There are many other causes of hydrocephalus besides spinabifida.” She ticked them off on her fingers. “It can result from brain hemorrhage. The inflammation and debris resulting from brain infections, such as meningitis, can block drainage pathways. Tumors can
“What other research do you do?”
“A tremendous amount of groundbreaking work has emanated from the MNI. The development of electroencephalography, the concept of focal and generalized epilepsies, new methods of frameless stereotactic surgery, contributions to postglandin biochemistry in the nervous system, localization of dystrophin skeletal muscle. I could go on and on.”
I was certain she could. Dr. Russell was obviously proud of her employer. I smiled encouragement, though I understood only part of what she had listed.
She leaned back and laughed. “I’m sure you are not here for a lecture on the Neuro.”
“No, but it’s fascinating. I wish I had more time. But I know you’re very busy and I don’t want to take up any more of your day than necessary.”
I took the container from my purse and handed it to her. She looked at it, then unscrewed the cap and slid the implant onto a piece of paper on the blotter of her desk.
“This is an old one,” she said, turning it over with a pencil. “I don’t think they’ve made this model for years.”
“What is it?”
“It’s a ventriculo-peritoneal shunt. They’re implanted for the treatment of hydrocephalus.”
“Hydrocephalus?” I knew the term, but was surprised to hear her say it. What other misfortunes would I learn about this child?
“It’s commonly known as ‘water on the brain,’ but that’s not really accurate, although that’s a literal translation from the Greek, hydro being water, and cephalus being head. Cerebral spinal fluid is constantly produced in spaces in the brain called ventricles. Normally it circulates through the four ventricles, and flows over the brain’s surface and down the spinal cord. Eventually the CFS is absorbed into the bloodstream, and the amount of fluid and pressure in the ventricles stays within acceptable limits.
“But if drainage is blocked, fluid will accumulate, causing the ventricles to swell and press on the surrounding tissue.”
“So hydrocephalus refers to an imbalance in the amount of CSF produced and the rate at which it drains from the ventricles.”
“Exactly.”
“And, as the CSF builds up, it causes the ventricles to enlarge and the pressure inside the head to increase.”
“You’ve got it. Hydrocephalus can be acquired or congenital, which is not to say hereditary. The term simply means the condition is present at birth.”
“I found the shunt in a normal-looking skull. Doesn’t hydrocephalus result in increased head size?”
“Only in infants, and only if left untreated. As you know, with older children and adults the bones of the skull are already formed.”
“What causes it?”
“There are lots of reasons for inadequate CSF drainage. Prematurity puts an infant at high risk. And most babies with spina bifida have hydrocephalus.”
“Spina bifida involves a neural tube defect?”
“Yes. The problem occurs during the first four weeks of gestation, often before the mother knows she’s pregnant. The embryo’s neural tube, which develops into the brain, spinal cord, and vertebral column, fails to form properly, leading to varying degrees of permanent damage.”
“How common is it?”
“Entirely too common. It’s estimated that spina bifida affects one in every thousand babies born in the United States, and about one in seven hundred and fifty born in Canada.”
“I recovered no vertebrae, so I have no way to know if my young lady had spina bifida.”
Russell nodded in agreement, then continued her explanation.
“There are many other causes of hydrocephalus besides spinabifida.” She ticked them off on her fingers. “It can result from brain hemorrhage. The inflammation and debris resulting from brain infections, such as meningitis, can block drainage pathways. Tumors can
Similar Books
