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An Ommaya reservoir is a medical device used to deliver chemotherapy medications directly to the cerebrospinal fluid. The reservoir is implanted under the scalp and attached to a catheter threaded into one of the ventricles of the brain. In addition to being used to deliver medications, this device can also be utilized for taps or draws of cerebrospinal fluid. It is implanted under general anesthesia by a neurosurgeon on the recommendation of an oncologist who feels it is necessary for cancer treatment.
Cancers in the central nervous system are notoriously difficult to treat. Chemotherapy drugs delivered orally or intravenously may not be able to pass the blood-brain barrier, or cannot pass in large enough quantities to provide meaningful treatment. An Ommaya reservoir allows physicians to deliver treatment directly to the source. The device is named after the Pakistani surgeon who invented it in the 1960s.
When an Ommaya reservoir is placed, the patient is put under general anesthesia and the surgeon makes an incision in the scalp to access the skull. A hole is drilled so the catheter can be placed and the reservoir is inserted under a pocket in the scalp. The incision is closed and the anesthesiologist brings the patient out of anesthesia. Patients may spend several days in the hospital while they heal and are assessed for cognitive deficits and lung function to confirm the absence of surgical complications.
To deliver medications into the Ommaya reservoir, injections can be made through the scalp and into the reservoir. Catheters can also be inserted to drain cerebrospinal fluid for testing and other reasons. The reservoir may be left in place once the patient goes into remission in case of recurrence. If a patient remains stable for an extended period of time, a surgeon can discuss removal of the Ommaya reservoir in a second surgical procedure.
It is not uncommon to implant devices like Ommaya reservoirs and ports to access the venous network for cancer treatment. Cancer treatment can be grueling and patients may need numerous sessions of chemotherapy. Having a ready access point can improve patient care, reduce the risk of complications, and minimize skin and tissue damage as a result of repeated new injection sites. However, patients also need to care for their fixed catheters, as there is a risk of infection. Patients will be provided with detailed catheter care instructions before and after surgery and they are encouraged to ask questions about catheter care so they know what to expect.
My father developed severe fatigue/weakness/lack of coordination and the neurologist recommended that the Ommaya reservoir be removed. It was and he was "fine" for a couple of years but now has developed the same problem, though now in "spells" that have landed him in the hospital at least three times, going through a battery of tests, CT scan, EEG, chest x-ray, lumbar tap, all of which are negative.
Any ideas as to what this could be? He has an extensive history including bone marrow transplant and chemo but is supposedly cancer-free right now. Need help. No one has any ideas about what could be wrong and how to "fix" it.
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