An Upstate Medical University doctor and researcher has been awarded a Department of Defense grant to continue testing if a dangerous brain condition can be treated through medication rather than surgery.

Satish Krishnamurthy, MD, MCh, FAANS, is a professor of neurosurgery at Upstate and has been treating and studying hydrocephalus, or water on the brain, his entire career. Hydrocephalus commonly occurs after a brain injury sustained by those in the military, and in children who are born prematurely. Having hydrocephalus significantly increases physical and cognitive disability.

Krishnamurthy’s project is studying how proteins and other cellular debris in the brain resulting from injury attract more fluid into the ventricles resulting in hydrocephalus. The study has identified “efflux transporters,” which are part of the blood vessels in the brain that remove these proteins, as critical to removing excess water from the brain. 

Typically, treatment of hydrocephalus is treated with a shunt, which is a drain surgically inserted into the skull to release the water. Despite being the most common treatment for this problem, shunts have high instances of blockages and infections and frequently have to be repaired or replaced, Krishnamurthy said. To remove excess water on the brain with a medication rather than a shunt could be a medical breakthrough, Krishnamurthy said.

“These transporters function differently in different people and under the influence of different medications,” Krishnamurthy said. “Whether efflux transporters play any part in clearing these proteins and therefore prevent or treat hydrocephalus is not proven. Induction of efflux transporters can be used for treatment and even prevention of post traumatic hydrocephalus.”

The two-year discovery award from the DOD in the amount of $324,000 funds Krishnamurthy’s project entitled, "A Novel Nonsurgical Approach to Treat Post-Traumatic Hydrocephalus.” Jie Li, MD, a research scientist in the department of neurosurgery has worked with Krishnamurthy for many years and has been instrumental in this project.

The Department of Defense is investing resources into how to better treat traumatic brain injuries in soldiers, Krishnamurthy said, but finding a pharmaceutical approach to treating hydrocephalus could have widespread impact on the medical field far beyond the military. Solutions for soldiers can also be used to treat hydrocephalus caused by premature births in children and other causes, he said.

“Our long-term goal to find an effective pharmacological treatment for hydrocephalus will be feasible and hopefully reduce the burden of treatment of this disabling condition to the patients and their families,” Krishnamurthy said. “In two years we will have enough data to say whether these medications that work through efflux transporters are effective. It’s terrific. We are all very excited.”