Paediatric neorosurgery - Irish facilities?
We have a little boy, who at six weeks old was given a v.p. shunt for hydrocephalus. This was necessary following the removal of a posterior fossa haemangioma. We are currently living in North America and intend to move back home to the Midlands. Our concern is, if our child is showing symptoms of shunt failure, do we travel to Beaumont or are there any other hospitals closer to our area that can diagnose and deal with this problem? Our little boy is doing well and is now two years and eight months old.
A haemangioma is a benign growth consisting of a knot of newly formed blood vessels. They commonly occur on the face and most people would be familiar with them as a congenital birthmark such as the strawberry mark. However, they can occur in other parts of the body and in the case of your little boy it happened to occur within his skull. The posterior fossa is a depression in the interior of the skull where the cerebellum and brain stem are located. You mention that the haemangioma was successfully removed but that your son needed to have a shunt inserted in order to relieve hydrocephalus. Hydrocephalus is the technical term for an increase in fluid pressure on the brain and is often referred to colloquially as “water on the brain”. The shunt is a form of drain that prevents a pressure build up inside the skull by simply draining the fluid from the skull. The v.p. shunt you refer to is a ventriculoperitoneal shunt, which drains the fluid from an area in the brain, called the ventricle into the peritoneal cavity, which is situated in the abdominal cavity. Put simply, your little boy has a small diameter tube draining fluid from his skull into his abdomen. As you are already aware these shunts can fail, which means that the fluid is not draining properly, which can lead to a gradual return of the hydrocephalus or increased fluid pressure. You say that you are returning to live in the Midlands and specifically ask if there is a centre closer to your home than the unit in Beaumont. There is a neurosurgical unit located in Cork University Hospital. The hospital website address is http://www.shb.ie/class-17674347.cfm. I would suggest that you request that your current medical team in the United States make contact with the doctors in the Cork unit so that the relevant medical information on your son can be transferred. I would also suggest that your prospective GP in Ireland should also receive this information.