Research and Clinical Trials
Hydrocephalus is one of the most common congenital conditions in children. It may affect a child’s brain development, ability to learn and understand, memory and social skills.
Treatment has improved over time. But children with hydrocephalus still face many challenges. One main challenge is the risk that their shunts will get infected or fail. If this happens, a child must have multiple surgeries to replace the shunt.
We are known internationally for addressing these problems. We work to improve shunt design, prevent shunt infections and research why and how hydrocephalus happens. Our team, led by Dr. Samuel R. Browd, includes doctors and surgeons, bioengineers and scientists.
Shunts fail at a very high rate. Nationwide, 30% of first shunts fail within the first year and 98% fail by 10 years. Seattle Children’s Center for Integrative Brain Research is a leading center for improved shunt design and technology. We combine basic science and bioengineering on projects such as:
- Studying shunts that have failed and been removed to look for clues for better design. Using a microscope, we examine the catheter that goes into the brain. We study how a patient’s cells stick to it, blocking the flow of cerebrospinal fluid (CSF). This work may lead to improvements like changing the structure of catheters or creating a coating to keep cells from sticking.
- Researching an automated device that tracks pressure inside the skull and drains CSF out of the brain and body as needed. Researchers believe this approach can improve shunts implanted in people with hydrocephalus. Read about the automated device.
We have one of the lowest shunt infection rates in the nation. Our rate is 3%, compared to national rates as high as 15%. Our research team keeps working on ways to prevent infections and treat them more effectively when they happen.
- We are studying if we can lower the risk of future infections by changing how long we wait after an infection before we implant a new shunt.
- Genetic sequencing helped Dr. Tamara Simon and her colleagues find more than 100 different pathogens in the cerebrospinal fluid (CSF) of children with shunt infections. This was the first time that many of the pathogens were linked with shunt infections. This research could lead to new ways to treat shunt infections or prevent them entirely. Simon suspects that these infections are so hard to treat because of biofilms that grow on shunts. Biofilms contain many types of pathogens that are only active some of the time, so current tests don’t always find them. Read more about this research discovery.
Research in the lab increases our knowledge and understanding of hydrocephalus, including why and how it happens. This type of research is key to discovering new treatments and finding a cure.
Dr. Ghayda Mirzaa at Seattle Children’s Research Institute leads our science research into hydrocephalus. Her team and our doctors who treat patients are working to:
- Understand the genetic basis for hydrocephalus to help develop new ways to treat it.
- Study proteins in cerebrospinal fluid (CSF), which may give us clues about why hydrocephalus happens. This could lead to treatments that do not include surgery.
- Create a database to allow genetic research and maintain a tissue bank of CSF for research purposes. The Hydrocephalus Research Guild supports this work.
We belong to the Hydrocephalus Clinical Research Network (HCRN). In this group, leading children’s hospitals work together on clinical trials to improve hydrocephalus care for children. Dr. Jay Hauptman leads the HCRN efforts at Seattle Children’s, with Dr. Browd as senior researcher.
HCRN research aims to:
- Reduce infections related to shunt surgery
- Improve treatment of shunt infections
- Learn which patients can benefit most from endoscopic third ventriculostomy (ETV), a surgery to treat some forms of hydrocephalus without a shunt
- Create a detailed registry of patients at HCRN hospitals to track trends over time and plan future studies
- Use ultrasounds to improve shunt placement and avoid the need for replacements
- Manage hydrocephalus in children who are born early (prematurely)
Providers, see how to refer a patient.