Comprehensive Treatment for CSF Disorders

Published in Winter 2016

Everyone has cerebrospinal fluid (CSF). In fact, CSF helps to protect our brain by cushioning it within the skull, and also serves as a shock absorber for the central nervous system. CSF also circulates nutrients and chemicals from the blood and removes waste products from the brain. However, sometimes, CSF can leak from the brain, or it can build up in the skull and cause the brain to swell (a condition called hydrocephalus). Both CSF leaks and hydrocephalus fall under the umbrella of CSF disorders.

Diagnosing and treating CSF disorders—which also include pseudotumor cerebri, and cerebral and spinal cord cysts—by a single group with concentrated expertise significantly benefits patients, says neurosurgeon Mark Luciano, M.D. , Ph.D. “These conditions are difficult to treat effectively,” he says. “Patients often lack specialists in CSF disorders with the necessary knowledge to fully address their condition.”

That’s why Dr. Luciano and neurology colleague Abhay Moghekar, M.B.B.S., co-direct the Hydrocephalus and Cerebral Fluid Center, where other neurosurgeons, neurologists, pain experts and therapists treat patients together.

One of the most common disorders seen through the program is adult hydrocephalus, explains Dr. Moghekar. Though hydrocephalus is often thought of as a pediatric disorder, it’s typically treated with shunts, which require lifelong care. Patients who age out of pediatric care can have difficulty finding a specialist willing to follow up with them in adulthood. "We can help patients make a comfortable transition from pediatric to adult care," Dr. Moghekar says.

Adults also suffer from a unique type of hydrocephalus known as normal pressure hydrocephalus (NPH). This problem can be difficult to diagnose because its symptoms, including difficulty walking, decline in thinking skills and loss of bladder control, are common to many other diseases. NPH in particular requires the type of comprehensive, multidisciplinary care available only through a model like the Hydrocephalus and Cerebral Fluid Center.

Other conditions under the CSF disorders banner require their own unique combination of expertise, Dr. Luciano adds, including geriatrics, ophthalmology, pain medicine and other specialties. "We truly provide a comprehensive combination of medical and surgical services to treat patients as effectively as possible."

For more information or to make an appointment at the Hydrocephalus and Cerebral Fluid Center, call 410-955-7482.

This article used excerpts from the Fall 2015 issue of Johns Hopkins NeuroLogic.