Brain Drain

Mexico

5’12

Script:

V/O: An emergency operation at the institute of Neurology and Neurosurgery in Mexico City. 36 year old Lorena Martin had been suffering headaches and nausea. She’s been diagnosed with Hydrocephalus, or water on the brain. In newborn babies it causes grotesque swelling of the head. In adults it leads to massive pressure on the brain, and death. The only solution is to drill a hole on the skull., insert a catheter, and drain the fluid. It sounds simple enough, but, until now, it’s been fraught with complications. Patients have often ended up back on the operating table. But Mexican neurologists believe they now have the answer: An artificial drainage system that last the patient for life.

Guillarme Ibarra developed Hydrocephalus a couple of years ago. At first he would just passed out, but then it progressed and at times he would be paralysed.

I/V: I remember one occasion very well. I was in the patio when I fell over. I fell over backwards. My son had to lift me.

I/V He became very quiet and very withdrawn. He wasn’t the wise guy he is now, and that he was before.

V/O Guillarmo was transferred to the Institute of Neurology and Neurosurgery. Head of the team there is Julio Cetello, an expert on hydrocephalus.

I/V: This is a typical case of hydrocephalus. We can see just how swollen the ventricles are. Normally they are just tiny cavities in the brain.

V/O: Inside the brain, four cavities called ventricles, contain fluid. But when the ducts that normally drain this fluid become blocked, the fluid can’t escape, and pressure increases on the brain. A tube must be surgically inserted into the patient to drain the fluid, into the abdomen, where it is reabsorbed into the body.

I/VYou make a hole in the head, in the bone, so you can insert the catheter into the ventricles, which contain the fluid. You connect it to this: the abdomen catheter, which goes under the skin, directly to the abdomen, and that’s where the fluid drains.

V/O. The tube must be left permanently inside the patient, or fluid will simply build up again.

I/V The problem is that the great majority of drainage systems draw off either too much liquid or too little: there’s either over drainage or under drainage.

He believes the problem lies in the valve system, which is used to control the flow of liquid. It can easily become blocked, and it also functions differently depending on whether we are upright or lying down.

I/V: Two thirds of the day we are in an upright position, either seated or standing. This affects the system terribly, because it produces a suction effect. It produces an effect whereby the force of gravity draws the liquid down. It doesn’t matter how the valve works.

I/V: It took years of work, but Dr Cetello came up with a simple solution: a tube without a valve. Instead the control of fluid was controlled by the incredibly narrow diameter of the tube, just four hundredths of a millimetre.

I/V: This diameter manages to counter the effect of the suction gravity exercises on the flow of the liquid, whilst at the same time permitting an adequate flow of liquid when the patient is lying down.

The pressure of the liquid building on the brain is perfectly balanced with the force of gravity, and the continuous flow means it is not subject to the same dangers of clotting as the old valve system, despite its narrowness. Guillermo is now the proud owner of this new valveless catheter.

I/V: It comes here, it comes down here and this is where water comes out. And that’s how they do it.

I/V Its an extraordinarily versatile system, which can be used for any type of hydrocephalus. The longterm results already indicate that it functions well in the majority of patients.

I/V: The fact I it was a Mexican invention, by Dr Julio Cetello, makes me doubly proud. For myself as Mexican, and for them, as Mexicans.

Thanks to Dr Cetello, the pioneering Mexican technology that saved Guillermo may soon be available throughout the world.