Carly has been up and down since her last surgery, with waves of neurologic discomfort. The last shunt did last a bit longer, but it has slowly been showing signs of becoming obstructed and she needed surgery this afternoon. Dr. Gupta wanted to try something new that could potentially extend the time between her surgeries. The procedure is called a third ventriculostomy, and he made a hole at the base of the third ventricle to provide another avenue for Carly's CSF to exit her brain.
To make the hole he first needed to remove a nodule that was sitting in the way. We have been monitoring this nodule, and another one in a different area of Carly's brain on the last few quarterly MRI's. The nodules have been fairly stable in size, but the neurosurgery team has recently deemed them concerning and likely tumor recurrence. Dr. Gupta said the nodule he removed today did look like tumor and we should get pathology results in the next few days. He was able to safely make the hole in Carly's third ventricle with minimal bleeding. Because this procedure went well and was free of excessive bleeding he also performed a shunt revision. Two parts of the shunt were visibly obstructed and replaced, and she now has a fully functioning shunt #40 in place. The surgery took five hours in all, but Dr. Gupta was happy with the outcome. Carly is resting now in the PICU and will hopefully have a quiet night. We hope that this is just what she needed to feel good.