Madison had her MRI today, and the cause of her discomfort is definitely neurological. The shunt that was placed last week is working, and the ventricle on the rear right is significantly smaller in size. The area the brain that had been compressed has also expanded to fill the space again. However, the ventricle on the right front has re-expanded. The doctor thought the fluid-filled spaces all along the right side could be connected by punching holes in the walls such that they would all drain through a shunt in the back. Unfortunately, the front is not communicating with the back, so fluid is accumulating in the front. In addition, the spaces all along the left side of her brain have grown. So, Madison will undergo yet another shunt revision. A second catheter that is already in place on the right front from her previous shunt will be connected up with the valve that is draining the right rear. That should take care of the fluid accumulation on the right side. The surgeon will also place a third catheter on the left side and attach that to the valve as well. Hopefully, the single catheter will drain the entire left side, but a second catheter might be required if the left front and left rear don’t communicate, as is happening on the right side. Less catheters is better as it means there are less pieces that can malfunction in the future.
Her fourth ventricle (in the center but below the left and right ventricles) is also enlarged. She is still too young for surgery on the fourth ventricle, and hopefully it won’t get too big too fast. Ideally, she can hold out until she is closer to a year old before that needs to be addressed.
Madison has been re-admitted to the NICU at The Children’s Hospital, and we will let people know how the surgery turns out after Wednesday.