What to Know About an Ommaya Reservoir

An Ommaya Reservoir is a small, plastic device that is implanted in your brain. It allows your doctor to deliver medicine directly to the fluid around your brain and spinal cord. It also allows your doctor to take samples of the fluid around your spinal cord to test it.

Why Would You Need an Ommaya Reservoir?

The Ommaya Reservoir was originally developed by a Pakistani neurosurgeon named Ayub Khan Ommaya in 1963. He developed it to deliver antifungal medicines directly to the cerebrospinal fluid (CSF). This is the fluid in the tissues that surround your brain and spinal cord. It was needed because a lot of medicines can’t cross the blood-brain barrier.

Your blood vessels carry blood from your heart to all of your organs. Your central nervous system (CNS) includes your brain and spinal cord. The blood vessels in your CNS work differently than the rest. They tightly control what passes from your blood into your brain. This is called the blood-brain barrier.

An Ommaya Reservoir has several different uses. They include:

  • Treating brain tumors
  • Treating cancer pain
  • Treating chronic or recurrent central nervous system infections
  • Preventing CNS disease in people who have acute lymphoblastic leukemia, a type of blood cancer
  • Treating leptomeningeal metastases, which is when cancer from one part of your body spreads to the tissue around your brain or your cerebrospinal fluid
  • Taking samples of your CSF to test
  • Draining cysts that can develop in your brain with some types of cancer
  • Treating hydrocephalus, which is when fluid builds up in your brain and needs to be drained

How Is an Ommaya Reservoir Implanted?

Neurosurgery. An Ommaya Reservoir is implanted in your brain by a neurosurgeon. It consists of two parts. One is a quarter-sized soft plastic reservoir dome. The other is a catheter, which is a thin flexible tube.  

The dome is placed directly under your scalp and connected to the catheter. The other end of the catheter is placed in a ventricle in your brain. A ventricle is one of four hollow areas in your brain that contain CSF. 

No contact sports. After the Ommaya Reservoir is put in, you'll have to avoid contact sports for 6 weeks while the area heals. After that, it won't need any special care. You can wash your hair and do your normal activities as usual.  

Let your doctor know if you have any of the following symptoms after your procedure:

  • Redness, swelling, or pain around the Ommaya Reservoir
  • Discharge around the reservoir, including blood, pus, or clear fluid
  • Fever of 100.4 degrees Fahrenheit or higher
  • Neck stiffness
  • Headache
  • Vomiting
  • Confusion
  • Blurry vision

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How Do You Prepare for Surgery?

Talk to your doctor about all of the medicines you take and your medical history. Let them know if you drink, smoke, or use drugs. You will have to have some testing done before the surgery. Additionally, you may need to stop taking certain supplements and medicines up to 10 days before your surgery. Some of these are:

You may also need to: 

  • Avoid hair styling products such as gel or hairspray before your surgery.
  • Get a good night's sleep the night before.
  • Don't eat or drink after the time given in your instructions.
  • Take medicines if your doctor told you to with just a sip of water.
  • Follow all instructions you were given before surgery.

How Is an Ommaya Reservoir Used?

Ommaya Tap. Once your Ommaya Reservoir is placed, your doctor can use it to take a sample of your cerebrospinal fluid or give you medicine. This is done during a procedure called the Ommaya Tap. It only takes about 15 minutes. Your healthcare provider will gently press on your scalp a few times to pump the reservoir. This will fill it with CSF.  

Testing. A syringe with tubing attached to it will be used to extract a small amount of CSF from the reservoir. Your CSF will be sent to a lab to check for infection or cancer cells. If you're receiving medicine, it will be injected into the reservoir after the CSF is removed.

What Are Possible Complications of an Ommaya Reservoir?

All surgeries carry some risks. The risks of placing an Ommaya Reservoir can include:

  • Bleeding
  • Infection
  • Neurologic impairment, which is a problem with how your central nervous system functions
  • Failure of the reservoir
WebMD Medical Reference

Sources

SOURCES:

Cold Spring Harbor Perspectives in Biology: "The Blood-Brain Barrier."

Memorial Sloan Kettering Cancer Center: "About Your Ommaya Reservoir Placement Surgery for Pediatric Patients," "Frequently Asked Questions About Ommaya Reservoirs and Ommaya Taps."

Oncology: "Optimal use of the Ommaya reservoir in clinical oncology."

StatPearls: "Ommaya Reservoir."

UPMC HILLMAN CANCER CENTER: "Ommaya Reservoir."

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