Hydrocephalus is a condition in which cerebrospinal fluid (CSF) accumulates in the brain's ventricles, causing increased pressure that can damage brain tissue. It can be present from birth — often linked to spina bifida or aqueductal stenosis — or develop later from bleeding, infection, tumor, or normal pressure hydrocephalus in older adults. Shunting and endoscopic third ventriculostomy are the primary treatments but carry long-term complication risks.
What's actually going on in research
Ventriculoperitoneal (VP) shunts remain the most common treatment but have high failure and infection rates over years. Endoscopic third ventriculostomy (ETV) is now preferred for obstructive hydrocephalus in appropriate patients and avoids permanent implant. Trials are focused on improving shunt technology — including programmable, anti-siphon, and antibiotic-impregnated catheters — as well as on better understanding normal pressure hydrocephalus (NPH) in elderly patients, where diagnosis and patient selection for surgery are imprecise.
Advanced shunt technology
Next-generation shunts with programmable valves, anti-siphon mechanisms, and antibiotic-impregnated catheters are in trials to reduce malfunction and infection rates in pediatric and adult hydrocephalus.
Normal pressure hydrocephalus
Trials are studying improved diagnostic criteria, shunt selection, and predictors of cognitive and gait recovery after shunting in NPH, where current patient selection remains imprecise.
Neuroendoscopic techniques
Refinements to endoscopic third ventriculostomy technique and combined ETV/choroid plexus cauterization are being evaluated in infants and in populations where traditional shunts are problematic.
What to know before you search
Eligibility varies by hydrocephalus etiology, age, ventricular anatomy, and prior shunt or surgical history.
What types of trials are currently open
- Shunt device trials — Testing programmable, anti-siphon, and antibiotic-impregnated shunt systems to reduce malfunction and infection.
- NPH diagnosis and treatment trials — Improving patient selection and measuring cognitive and mobility outcomes after shunting for NPH.
- Neuroendoscopic procedure trials — Evaluating ETV and combined ETV-choroid plexus cauterization in pediatric and congenital hydrocephalus.
- Infection prevention trials — Testing antibiotic regimens and catheter coatings to reduce shunt infection in high-risk patients.
- Neurodevelopmental outcome studies — Tracking long-term cognitive and motor outcomes in children treated for hydrocephalus from infancy.
Recently added Hydrocephalus trials
Flow Detection in Open and Closed Shunt Valve Periods
This study is evaluating a new, noninvasive device designed to detect whether cerebrospinal fluid (CSF) is flowing through a surgically implanted shunt. CSF shunts are commonly used to treat hydrocephalus, but it can be difficult to tell whether a shunt is working properly without invasive testing or imaging that does not directly measure flow. The study device is a small, wireless sensor placed on the skin over the shunt tubing, typically near the collarbone. It uses gentle, controlled warmth to measure temperature changes that indicate whether fluid is flowing inside the shunt. The device does not break the skin and does not change a participant's medical care. This study will enroll children and adults who already have a CSF shunt and who do not have new or worsening symptoms of shunt malfunction. All participants will have a measurement taken while their shunt valve is at its usual prescribed setting. Some participants with programmable shunt valves will also have a second measurement taken after their valve is temporarily adjusted to a setting intended to stop or greatly reduce flow ("virtual off"). After this measurement, the valve will be returned to its prescribed setting. The study device results will not be shown to participants or their medical providers and will not be used to make treatment decisions. The goal of the study is to determine how well the device can distinguish between shunts that are allowing flow and those that are not. Participants will be monitored for a short period after device use and, if applicable, after any valve adjustment. The main risks of participation are mild skin irritation from the adhesive or temporary symptoms related to valve adjustment. Participants are not expected to receive a direct medical benefit, but the information gained may help improve future diagnosis of shunt function.
Crystallization of LA and Adjuvant Mixtures in Cerebrospinal Fluid
Different mixtures of local anesthetics or local anesthetics with adjuvants that are known to precipitate in vitro are tested in human cerebrospinal fluid (CSF). CSF is gained from patients with normal pressure hydrocephalus scheduled for elective lumbar puncture. Patients signed an ICF for leftover samples. CSF will be assessed for pH values at different timepoints (t0-t3; 0 to 60 minutes). In a second step six commonly used mixtures of LA with LA or LAs with adjuvants will be mixed using the following mixture ratios: ropivacaine 0.75% + lidocaine 2% (ratio 1:1), ropivacaine 0,75% + mepivacaine 2% (ratio 1:1), ropivacaine 0.75% + chloroprocaine 2% (ratio 1:1), lidocaine 2% + sodium bicarbonate 8.4% (ratio 1:0.1), ropivacaine 0.75% + lidocaine 2% + sodium bicarbonate 8.4% (ratio 1:1:0.1) and ropivacaine 0.75% + dexamethasone (1.5:1). The used mixture ratios are inspired by commonly mixtures described in the current literature and have been proven to precipitate in vitro. For every mixture, a Grade of Crystallisation will be determined at baseline without CSF and then at t0 (immediately) to t3 (60 minutes) every 15 minutes.
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