ps - his ‘migraines’ could easily be from high pressures but many, probably most, shunt patients have lifelong headache issues.

Most neurologists just don’t know enough about hydrocephalus to really understand treatment issues and the imaging. If you are in the US it is less likely that treatment is worked through a neurologist. Outside the US we’ve had treatment that was through a neurologist and while we had a fantastic neurologist for the 2.5 years we were abroad, there is no comparison to the surgeons we have worked with and it was a rather uneventful period for our child. We’ve had neurologists in the US who are at a highly rated pediatric research hospital and only the neurologists who worked with moyamoya or epilepsy had a better clue than, yet still not in the same ballpark as the pediatric neurosurgeons.