Shunt Complications? (2023)

FAQs

Shunt Complications? ›

Ventriculoperitoneal (VP) shunt complications include blockage and infection. Early and prompt detection of shunt dysfunction is vital as delay can lead to markedly raised intracranial pressure, coning and death. All patients with suspected VP shunt dysfunction should be discussed with neurosurgery.

Ventriculoperitoneal (VP) shunt complications include blockage and infection. Early and prompt detection of shunt dysfunction is vital as delay can lead to markedly raised intracranial pressure, coning and death. All patients with suspected VP shunt dysfunction should be discussed with neurosurgery.

Over-drainage: When the shunt allows cerebral fluid to drain from the brain's ventricles more quickly than it is produced, the ventricles can collapse, tearing blood vessels and causing bleeding in the brain or blood clot, marked by severe headache, nausea, vomiting, seizure and other symptoms.

The shunt event-free survival is approximately 70% at 12 months and is nearly half that at 10 years, post-operatively.

The risk of shunt failure is greatest within the first year of insertion, estimated to be 10% to 20%, depending on the underlying cause of the hydrocephalus. The subsequent failure rate is about 5% per year after this. Infection is a dreaded complication, especially in patients who are shunt dependent.

A shunt blockage can be very serious as it can lead to a build-up of excess fluid in the brain, which can cause brain damage. This will cause the symptoms of hydrocephalus. Emergency surgery will be needed to replace the malfunctioning shunt.

Shunt malfunction is most commonly due to a blockage or some obstruction within the shunt system.

Highlights. Obstruction is the most common cause of ventriculoperitoneal shunt (VPS) malfunction. Infection is the second most common cause of VPS malfunction, which is more common in children. Pseudocyst is a late complication of VPS, which may present as abdominal pain and a palpable mass.

All younger patients with a shunt should probably be encouraged to seek a neurosurgical check up at least every three years, ideally at a dedicated hydrocephalus follow up clinic.

How long does it take for a shunt to fail? ›

About 4% of VP shunts will fail within two years of implantation, with a 98% failure rate over 10 years [1,4].

A shunt is said to have failed when any complication of the treatment of hydrocephalus requires surgery. Symptoms of a cerebral shunt malfunction may be obvious, redness over the shunt, headache, sleepiness, vomiting, or visual changes. Symptoms may also be subtle, change in behavior, change in school performance.

Many people with normal pressure hydrocephalus enjoy a normal life with the help of a shunt. Regular, ongoing checkups with the neurosurgeon will help ensure that your shunt is working correctly, your progress is on track, and you are free to keep living the way you want.

The longest living hydrocephalic is Theresa Alvina Schaan (Canada) who was born on the 17 March 1941 and diagnosed with having congenital hydrocephalus. Also known as "water on the brain," it is a condition in which there is extra cerebrospinal fluid (CSF) around the brain and spinal cord.

Shunt surgery is a relatively short and uncomplicated procedure that varies slightly depending upon two factors: The neurosurgeon's preference on where to place the upper (proximal) shunt catheter, which is the part that goes into your head.

VP shunts are likely to require replacement after several years, especially in small children. The average lifespan of an infant's shunt is two years. Adults and children over the age of 2 may not need a shunt replacement for eight or more years. Shunt systems require frequent monitoring and follow-up.

A brain shunt is used to remove a buildup of excess cerebrospinal fluid on the brain. When excess fluid develops, it increases the pressure inside the skull and can damage the brain. Symptoms of increased fluid on the brain include a headache, vomiting, and seizures. Eventually, brain damage and death can occur.

Among the causes of shunt failure, diagnosis of rare causes, such as shunt valve rupture, may be difficult and overlooked. In such cases, fibrous tissue might have surrounded the dysfunctional shunt part. CSF drainage might still continue through the fibrous tissue even in cases of a broken shunt.

Coexistence of brain vascular disease and hydrocephalus treated with ventriculoperitoneal shunt may predispose to acute ischemic stroke in case of shunt dysfunction and subsequent increased intracranial pressure (ICP).

Watch for signs of infection or signs that the shunt is not working right. If the shunt gets infected or stops working well, it may need to be removed or replaced. Without problems, your shunt may be left in place for years.

Can you feel a shunt in your head? ›

Inside the shunt there's a valve that controls the flow of CSF, so it does not drain too quickly. You can feel the valve as a lump under the skin on your scalp.

The clinical features of CSF shunt infection depend on the mechanism of infection, the causative pathogen, and the type of shunt. The most common clinical symptoms are fever, headache, nausea, and lethargy. (5, 10) Shunt infection is identified as the etiology of shunt malfunction in 3% to 8% of cases of malfunction.

Shunt revisions

A total of 47 patients (20.7%) underwent a revision surgery at some point during the follow-up period.

Biofilm forming bacteria such as Staphylococcus epidermidis and S. aureus attach to the surface of implanted devices to cause shunt infections.

Signs of a shunt malfunction include headaches, vision problems, irritability, fatigue, personality change, loss of coordination, difficulty in waking up or staying awake, a return of walking difficulties, mild dementia or incontinence. Fortunately, most complications can be handled successfully.

Survival in untreated hydrocephalus is poor. Approximately 50% of the affected patients die before 3 years of age and about 80% die before reaching adulthood. Treatment markedly improves the outcome for hydrocephalus not associated with tumors, with 89% and 95% survival in two case studies.

As the pressure inside the skull continues to increase, terrible headaches, sleepiness, paralysis, dementia, and other difficult symptoms occur. Left untreated, the pressure causes severe headaches, coma, and death.

Flying. Flying in a regular commercial jet is fine for most people with shunts. If you were told years ago not to fly, it's worth asking your neurosurgeon again as things have changed. Some people will have been told by their neurosurgeon not to fly, for specific reasons, so do check if this applies to you.

Most of the retrospective studies in the literature show higher rates of tube shunt failure between the third and sixth years, with upwards of 30 to 50 percent of tubes failing during that period.

You will not be allowed to drive until at least six months after your shunt is fitted.

Is walking good for hydrocephalus? ›

Slow, gentle exercises such as tai chi, chair yoga, and water exercise are less likely to cause falls and injuries. Exercise bikes and elliptical machines are also good options, as are activities that allow you to grab bars or handles to reduce the risk of falling. Walking is also a good activity, even with a walker.

Circular shunts are severe, life-threatening conditions. In a circular shunt, blood circulates through your heart without sending enough blood to the rest of your body. Circular shunts most commonly appear in severe forms of Ebstein's anomaly (EA).

VP shunts are generally safe, but there are some risks during and after the surgery. There can be bleeding, or an infection can develop.

Is Hydrocephalus a Disability? Yes, hydrocephalus can be considered a disability by the Social Security Administration (SSA) if you can meet a Blue Book listing.

Extremely low shunt pressure can cause headaches that are similar to spinal headaches. In these cases, headache complaints are minimal when the patient is lying down but become more severe when the patient sits up or stands. Migraine, a common affliction, can also occur in a person with hydrocephalus.

Hydrocephalus that develops in children or adults

The headache may be worse when you wake up in the morning. This is because the fluid in your brain does not drain as well while you're lying down and may have built up overnight. Sitting up for a while may improve the headache.

Memory and thinking skills are often slow to recover after shunt surgery, and some people may be left with cognitive deficits. The experts at Rusk Rehabilitation treat the cognitive challenges associated with normal pressure hydrocephalus through cognitive therapy.

The common outcome of early hydrocephalus is an uneven growth of intelligence during childhood, with nonverbal intelligence developing less well than verbal intelligence.

“The Partridge Family” alum and radio host Danny Bonaduce opened up about his health, a year after announcing that he was taking time to “focus” on it. In an video published by TMZ on Friday, the 63-year-old actor and wrestler said he has been diagnosed with hydrocephalus, also known as “water on the brain.”

Treatment. Normal pressure hydrocephalus is one of the few causes of dementia that can be controlled or reversed with treatment.

Does hydrocephalus worsen with age? ›

About one-third of people with NPH also have a degenerative brain condition like Alzheimer's disease. NPH becomes more common as you age, and many common, age-related health conditions can contribute to NPH and make it worse.

There are two types of CSF shunt valves: fixed and adjustable. Fixed shunt valves allow CSF fluid to drain when CSF pressure exceeds a certain “fixed” threshold. Adjustable shunt valves allow for changes to the amount of fluid that flows through the valve.

Your entire head won't be shaved. Your doctor will make 3 small incisions: 1 in your head, 1 in your neck, and 1 in your abdomen. These incisions will help guide the catheter so it can be placed correctly. The doctor will close the incisions with stitches or staples.

What is the success rate? The success rates depend on the age of the patient and the reason why the shunt is needed. Generally, there is around a 50% failure rate for ventriculoperitoneal shunts. The shunt tubing can become infected or obstructed requiring surgical revision.

By injecting a small volume of contrast dye or a radiotracer into the shunt reservoir, the flow of CSF through the catheters and valve can be measured. Shunt Tap is a diagnostic test to screen for infection and confirm that the shunt is still functioning.

Coexistence of brain vascular disease and hydrocephalus treated with ventriculoperitoneal shunt may predispose to acute ischemic stroke in case of shunt dysfunction and subsequent increased intracranial pressure (ICP).

The shunt can get worn out or move as a child grows. A shunt also can get infected, which can be very serious.

The ventricular catheter or valve is the most common site of blockage and can be caused by debris such as blood or excess protein in the CSF [1].

The longest living hydrocephalic is Theresa Alvina Schaan (Canada) who was born on the 17 March 1941 and diagnosed with having congenital hydrocephalus. Also known as "water on the brain," it is a condition in which there is extra cerebrospinal fluid (CSF) around the brain and spinal cord.