A ventriculoperitoneal (VP) shunt is a medical device which doctors use for treating hydrocephalus, a brain condition. The device can relieve pressure on the brain caused by fluid accumulation.
Hydrocephalus occurs when excess cerebrospinal fluid collects in the ventricles of your brain. This fluid cushions the brain and protects it from any skull injury inside. The fluid also acts as a delivery system for nutrients required by your brain and it also helps in taking away any waste product. Normally, this fluid flows through these ventricles to the base of your brain. After this, the fluid bathes the brain and spinal cord before it is reabsorbed into the blood.
When this normal flow gets disrupted, harmful pressure is created on the tissues of your brain, due to the buildup of excess fluid. This can lead to brain damage. VP shunts are therefore used by doctors, which they place inside of the brain’s ventricles to divert the fluid away from the brain so that normal flow can be restored.
People of any age might develop hydrocephalus, due to which they might require a VP shunt. However, it is known to occur more in babies than adults. Hydrocephalus, which occurs when excess fluid builds up around the brain, occur due to several reasons such as overproduction of cerebrospinal fluid, poor absorption of cerebrospinal fluid by the blood vessels and any blockage preventing fluid from flowing throughout the brain. Blockages are usually the most common cause of hydrocephalus.
Before the procedure, your doctor might recommend the following:
- Stopping consuming alcohol, as this might affect surgery and recovery
- Avoiding any herbal remedies or supplements
- Stopping taking vitamin E, as it may lead to bleeding
- Discussing any existing medication, as you might need to stop taking some before your surgery
- Discussing any heart devices and results of any tests for heart conditions
- Discuss if you have any allergies
- Stop smoking
On the night before your surgery, it is recommended that you don’t consume any food after midnight.
Before the procedure to fit the VP shunt, you will receive a general anesthetic and therefore you will be unconscious during the procedure. Once you are fully asleep, a small hole in your skull will be drilled through an incision behind the ear.
They will thread one catheter into your brain through this opening. The other one will go behind your ear and is subcutaneous, which means it resides under the skin.
This tube then travels down to the chest and abdomen, allowing any excess cerebrospinal fluid to drain into the abdominal cavity, where it is absorbed by the body. Your surgeon might then attach a tiny pump to both the catheters. This may be then placed under the skin behind the ear.
When the pressure in the skull increases, this pump will automatically activate to remove any fluid. It also may even be possible to program the pump also called a valve, to activate when there is a certain volume of increase in the fluid.
You might experience a mild headache after the surgery. In such a case, the doctor will give pain medications.
Eating normally straight after the surgery might not be possible. A patient might need to start with liquids and eventually move to solid foods slowly.
During your follow-up visit, your doctor will be removing your stitches. In the meantime, it is important to keep the stitches clean and also check for any signs of infection every day.
The doctor will remove a person’s stitches during a follow-up visit. In the meantime, it is important to keep the incisions clean and also check for any sign of infection. Redness, swelling and fluid leakage might be signs of an infection.
It is important to consult with your doctor before you are able to start showering again. The doctor will also advise you when you will be able to resume your normal daily routine.
For most people, a VP Shunt is able to successfully reduce any pressure in their brains. It takes several years before they require any replacement. For small children, the average lifespan of a shunt is two years. Adults and children over the age of 2 usually do not need a replacement for 8 or more years. However, the shunt systems need to be monitored frequently.
Risks and complications
The procedure for a VP Shunt has few risks. Some people can experience adverse effects due to the general anesthesia, such as breathing problems or changes in heart rate or blood pressure.
Although rare, sometimes a VP shunt can stop working correctly and require replacement. The following signs can indicate that the device may not be working as it should:
- redness or swelling where the catheter passes under the skin
- vomiting without feeling very nauseous
- loss of coordination or balance
- a persistent headache
- extreme fatigue
- trouble staying awake
- feeling of irritation
If a VP shunt stops working correctly, it is possible for it to over-drain or under-drain cerebrospinal fluid. If the pump drains cerebrospinal faster than the body produces it, it can lead to a brain hemorrhage. If the pump does not drain cerebrospinal fluid quickly enough, the symptoms of hydrocephalus will likely return.
It is also possible for the VP shunt to get infected. Signs of infection can include:
- • redness or swelling where the catheter passes under the skin
• pain around the catheter
• a headache
• high fever
If you see any sign of infection, it is important to see a doctor immediately.
FAQs on VP Shunt
How long does a VP shunt last?
VP shunts can last as long as for 35 years.
Can a VP shunt be removed?
VP shunt can be removed, once the shunt has been proven to be unnecessary.
How long does it take to recover from shunt surgery?
Recovery from a VP shunt placement takes 3-4 days. Most people can leave the hospital within seven days after the procedure.