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There are two paediatric neurosurgeons who provide specialist neonatal neurosurgical services for the whole of East Anglia.

 

The most common condition requiring neurosurgery in the newborn is known as hydrocephalus (or water on the brain). This is caused by a blockage in the normal flow of fluid which surrounds and protects the brain. The blockage can be caused by either a problem early on in the brain’s development (congenital hydrocephalus) or if born prematurely, following a bleed in the middle of the brain (intraventricular haemorrhage).

 

The diagnosis is usually made by scanning the brain with an ultrasound scan. Occasionally more sophisticated scanning, such as CT or MRI is required. All premature babies will have regular ultrasound scans of their brain in the first few days after birth to look for signs of bleeding. If the baby has had a bleed regular scans are done while he/she is in hospital to monitor the size of the fluid filled cavities in the centre of the brain known as the ventricles. If the ventricles are increasing in size this could be a sign of a blockage. Often it resolves on its own. Occasionally some fluid has to be taken out, but if the blockage persists a referral to the neurosurgeons is made.

The neurosurgeons may initially put in a 'reservoir’. This is a small plastic tube which is placed under the skin and allows the neonatal doctors to easily remove fluid from the ventricles. Very occasionally a shunt has to be put in. This is a very thin tube which drains fluid from the ventricles. The tube goes under the skin and into the abdomen so fluid is continually drained.