As a retiree, Glen was active and enjoyed spending time with family and friends in Perryville, Missouri. However, his life took an unexpected turn one afternoon when working in his shed; Glen fell off a ladder and hit his head on the concrete floor.
Glen’s wife, Margie, recalls that the fall didn’t seem to affect him much at first. “However, I noticed that as the months passed, Glen started having memory and balance problems and bladder control issues.”
To find the cause of the problem, Glen made an appointment with his primary care physician. However, after reviewing the results of a head computed tomography (CT) scan and magnetic resonance imaging (MRI), doctors couldn’t find a problem and thought he may have had a transient ischemic attack (TIA), or a ministroke, caused by a brief blockage of blood flow to the brain.
As his health issues persisted, Glen, once always cheerful, began to laugh less and struggled to maintain his usual positivity, weighed down by his condition's uncertainty.
Discovering the Cause
A few months later, Glen’s problems worsened. “One morning, he couldn’t get out of bed and lost consciousness. I called 911,” Margie says.
The ambulance took Glen to an emergency department in Perryville, where he had an MRI. After reviewing the results, the doctor saw that the ventricles—chambers in the brain that normally circulate cerebrospinal fluid (CSF)—were filled with fluid. Usually, the body produces just enough CSF each day and absorbs the same amount.
Specialized Care at MoBap
Glen was transferred to Missouri Baptist Medical Center (MoBap), an hour and a half north of Perryville, where he could get specialized care and treatment. When he arrived at MoBap, Glen was evaluated. Part of the initial assessment was to check his balance and walking gait. “At that point, I had a terrible headache and couldn’t get off the stretcher,” Glen says.
Jon Willie, MD, PhD, a WashU neurosurgeon, explains that when too much CSF builds up in the ventricles, it can lead to a condition called normal pressure hydrocephalus (NPH). “The cause of NPH is often unknown, and in Glen’s case, it may not have been related to his fall,” explains Dr. Willie. “With NPH, the extra fluid in the ventricles can cause them to press against nearby brain tissue, which can lead to walking difficulties, problems thinking or loss of bladder control.”
To diagnose NPH and see if Glen’s symptoms improved, MoBap interventional radiologists performed a lumbar puncture, or spinal tap, and removed excess CSF fluid. A few hours after the procedure, Glen’s headache was gone, and the next day, he could walk with a walker.
Placing a Shunt to Drain Fluid
Next, Margie and Glen met with Dr. Willie to discuss treatment options. Dr. Willie explained that having surgery to place a tube, called a shunt, in Glen’s brain would help drain the extra fluid and move it into his abdomen, where it would be absorbed by the body. This would lower the pressure and swelling in Glen’s brain and be a more permanent fix.
Glen and Margie both say they were immediately impressed with Dr. Willie because he took the time to listen to their concerns and answer their questions. Because of this, they felt they were in good hands and agreed with his treatment recommendations for Glen.
Following the placement of the shunt, Glen remained at MoBap for 10 days. During this time, Dr. Willie and the medical team continued to monitor Glen’s condition.
Small Improvements Add Up
While at MoBap, Glen started physical therapy to help his balance and stability, as well as occupational therapy to support his daily routine.
“The occupational and physical therapy team at MoBap work closely together to make sure patients receive comprehensive care,” says MoBap physical therapist Elinor Hibbing. “Glen had great family support and worked hard during his sessions.”
After his stay at MoBap, Glen was discharged to a rehabilitation facility close to his home in Perryville, before returning home. After the surgery and rehabilitation, Glen reports that he’s walking without help, and his memory is better.
In the year following his surgery, Glen has had regular follow-up appointments with Dr. Willie to make sure the shunt continues draining the right amount of fluid and that he continues to do well. “If the shunt drains too much or too little fluid, we adjust the settings during an office visit,” says Dr. Willie.
Reflecting on their time at MoBap, Margie says, “We had such a positive experience, and I was impressed with the high level of care we received throughout our stay. It’s been good seeing Glen’s sense of humor return.”
Even though he’s feeling better, Glen’s path to recovery has been a slow and steady journey, a testament to his resilience and the support of those around him.
Glen says, “This past year has had its challenges; however, I’m much better today than before surgery, thanks to the extraordinary care I received. Even though I’m still working toward my physical therapy goals, I’m thankful I had this surgery and would do it all again.”