The Hydrocephalus Program

Program Lead: Dr. Mark Hamilton

In 2003, the University of Calgary’s adult hydrocephalus clinic was established with the goal to standardize and enhance the care for adult patients with hydrocephalus. Hydrocephalus patients had typically been assessed and cared for by individual physicians in an unstructured and unfocused clinic environment. The population of adult patients with hydrocephalus is increasing as diagnostic and therapeutic techniques improve identification and survival of treated patients. Hydrocephalus represents a treatable cause for approximately five per cent of adult patients with a diagnosis of dementia. 

The Adult Hydrocephalus Program was developed in response to the strengths of the adult hydrocephalus clinic. A clinical research program was initiated and a basic science research program is in development. Targeting the care of adult patients with hydrocephalus in a specialty clinic has aided in understanding the natural history of adults with both treated and untreated hydrocephalus. The program has helped to standardize the treatment strategies for patients with a potential diagnosis of hydrocephalus and it has helped to improve the management of patients with hydrocephalus using shunts and endoscopic techniques. In 2018, there were about 3,000 patients followed in the adult hydrocephalus clinic. There were approximately 1,500 outpatient assessments and 180 surgical procedures performed. 

Highlights

  • Dr. Hamilton is the Chair for the Adult Hydrocephalus Clinical Research Network (AHCRN), which has two centres in Canada, five in the United States and one in England. AHCRN has enrolled 1,200 patients in 36 months and has starting a clinical trial for patients with normal pressure hydrocephalus (www.AHCRN.org).
  • Dr. Hamilton is a board member and president-elect of the International Society for Hydrocephalus and Cerebrospinal Fluid disorders (www.ISHCSF.com).
  • Dr. Hamilton is a member of the board of directors of the Hydrocephalus Association and the medical advisory board of the Hydrocephalus Association (www.hydroassoc.org).
  • Dr. Hamilton is helping to develop a Canadian hydrocephalus strategy and he is a member of the board of directors of Hydrocephalus Canada, which was inaugurated in November 2017.
  • Multiple Quality Improvement (QI) projects have been undertaken to improve patient access and surgical outcomes.
  • A formal protocol has been established to facilitate transition of care for pediatric patients with hydrocephalus when they turn 18 years of age.

Education

The Hydrocephalus Program offers fellowship training for neurosurgeons interested in subspecialty training in the diagnosis and management of adult patients. The first trainee completed his fellowship training in June 2012.

Research

  • Initiation of the Adult Hydrocephalus Clinical Research Network
  • Epidemiology of hydrocephalus
  • Transition care for pediatric patients with hydrocephalus
  • Neuroendoscopy treatment and outcome for adult patients with hydrocephalus
  • Neuropsychological effects of endoscopic treatment of patients with hydrocephalus 
  • Infections in patients with ventricular catheters and shunts
  • Improving surgical outcomes for treatment with ventriculoperitoneal and ventriculoatrial shunts
  • Treatment of patients with idiopathic normal pressure hydrocephalus
  • Endoscopic management of patients with ventricular brain tumours

Members

Neurosurgeons: Dr. Mark Hamilton, Dr. Clare Gallagher, Dr. Walter Hader

Medical and Surgical Assistant: Dr. Geberth Urbaneja

Neuro-ophthalmologists: Dr. Fiona Costello, Dr. Suresh Subramaniam

Geriatrician: Dr. David Hogan

Nurse Practitioner: Ron Prince, Patti Long

Research Coordinator: Jarred Dronyk

(Updated Dec. 2018)