It really depends on what they mean by ‘there are problems with my CSF flow’. CSF (cerebral spinal fluid) surrounds the brain and spinal cord. It performs a couple of roles. It nourishes the brain, removes waste and cushions the brain from impact. We produce around a pint (600ml) of CSF per day within the brain from areas called the Choroid Plexes. The fluid drains from the brain down through the spinal cord and is absorbed into the body, nourishing our nerves. If the CSF cannot naturally drain from the skull via the natural pathways we can develop a condition called hydrocephalus or 'Water on the brain", although it’s not actually water but rather a clear, nutrient rich solution.
There are a few differing types of hydrocephalus, the main two being communicating hydrocephalus and non-communicating hydrocephalus. Communicating hydro, in very basic terms, means there is some drainage of the fluid, non communicating hydro means there is no drainage or a blockage. There can also be an issue where the body’s ability to absorb the CSF produced can cause a problem.
" Does this mean surgery would be strongly advised?", Now that really depends on what the issue is. If it is an absorption issue there maybe medication that can be taken, if it’s a flow issue it maybe recommended to watch and monitor. If it is communicating, there may be enough flow for it not to be so much of an issue. If it’s non communicating it can depend on just where the blockage maybe, what’s causing it and how best to manage it. These are all questions that a neurosurgeon, with all of the scans and relevant information, would need to be consulted on.
"And without surgery would my symptoms worsen? " There can be many variables here and again it can depend on the type of hydrocephalus. If it is non communicating then (again, in VERY basic terms) yes. Producing 600ml/day and the fluid being blocked from draining can cause symptoms to worsen fairly rapidly. The skull is a sealed unit and there needs to be a balance of brain matter, blood and CSF with in it. Too much of one will decrease the space for another and this can increase symptoms.
If it’s communicating then there will be ‘some’ drainage occurring, it maybe enough to keep symptoms at a fairly stable level.
“Will long term CSF flow cause me any long-term problems?” Again it really depends on what they mean by “problems with flow” but in very layman terms, yes it can. But these are all things that need to be discussed with a qualified, knowledgeable neurologist or neurosurgeon as each person’s situation, diagnosis and prognosis can very greatly as can the treatments.
It is not unusual for medicos to send out letters with fairly vague information as they will need to fully examine the patient in consultation with the relevant scans. Personally I would suggest that if it was urgent, urgent, they would order you in before April, so I wouldn’t be stressing too badly at this point (I may make that out to be simple. I know it is not). There is very little to nothing you can do until you have had the relevant consultation, so stressing is not going to help.
My advice would be to make the appointment as requested, monitor yourself until your appointment and if you believe symptoms are increasing then get yourself to A&E.
Merl from the Moderator Support Team