Hunter Chapman: Hydrocephalus, Dysphasia, Brain Herniation, and Shunt Placement

Hunter first looks like a teenager whose behavior has changed, but the episode pivots when his speech problem points to the brain. The clinical stakes rise when hydrocephalus progresses to herniation.

Hunter Chapman is brought to the clinic by his mother because he is lethargic, irritable, and doing worse in school. A drug test is clean, but transient dysphasia prompts a head CT and labs. The CT shows hydrocephalus pressing near Broca's area; after Hunter collapses, Derek identifies brain herniation, talks Alex through emergency needle decompression to lower pressure, and then takes Hunter to surgery for a shunt draining fluid to the abdomen.

Hydrocephalus with dysphasia and brain herniation

Episode-supported steps include history from his mother, drug testing because intoxication is suspected, recognition of transient dysphasia, head CT, labs, and emergency reassessment after collapse.

Management in the episode moves from diagnostic testing to emergency pressure relief and shunt placement. Real care would also require neurosurgical consent, sterile setup, monitoring, and postoperative follow-up.