Shunt Complications? (2023)


Jess has a ventriculoperitoneal shunt (vp shunt) for hydrocephalus. It was first placed in 1988 when she was 6 months old. Jess did not have classic symptoms of hydrocephalus. Her hydrocephalus was discovered due to searching for the cause of Jessica's blindness. Because she didn't have classic symptoms in the past, we assume she wouldn't now either. So, anytime things are a little off, we have to check.

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Jess is 34-years-old, autistic, and blind. Her favorite topics of conversation include getting a new dog, her friend Keely, her Aunt Sue, and cousin Donna. Jess collects CD’s of children’s music, cards, coloring books, and has a small collection of used up disposable cameras that she refuses to get developed. Favorite health foods include chicken and rice, chicken tenders, chicken nuggets, chicken biscuits, pepperoni pizza, and hash brown potatoes. Jess has naturally curly hair that she would rather not ever comb, brush, or cut.

Jessica’s multiple disabilities stem from brain damage that occurred in-utero, and from hydrocephalus. In addition to autism and blindness, Jess also has minor fine motor and gross motor deficits. Hannah is Jessica's sister, and Marlow is Jessica's paid support staff (and Hannah's best friend.) Hannah is an ASL interpreter in the public school system. Jess also has a brother who is a senior neurology resident and lives in another state.


Hey, everybody, it's Val from Autistic, Interpretations., It's, early it's, almost 7, a.m on Tuesday and Jess has an appointment today at the doctor's office., She's, real nervous about it.

But a few minutes ago we had a very successful redirection at least for now.

She was stressing about how nervous she was and I told Hannah Jessica's already made a dirty garbage mess all over her bed.

This morning and Jessica got a big kick out of that.


A look.


Did you do that? She just made,? Oh I just made a dirty garbage mess.

Why? Why.

Did you do it?? I, don't, know!, Oh, geez., You know what your shirt says? uh-uh "I can if I want to because it's my business" Yeah, you're, right.

I made a dirty garbage mess.

Mama,I get some more cards.

Guess? What? ? I'll make another dirty garbage.


My gosh! Your, just full of dirty garbage aren't, you? yep., I'll, make the dirty garbage mess all over my new bed.

When I get it.

Oh, no., Oh, Daryl has a sock.

I wondered what was keeping him? Busy., No!, Oh, Here, Hannah.

My hands are full.

Oh ...

It's under my foot, whose was it? Hannah's, okay, will you shut the door to the new airfryer? ?, please?, I, gotta pee.


I mean, did you open the door to the air? Fryer?? Huh? Uh.


Think you probably did.

Hey Hannah.

Did you put your nugs up that you don't? Need?, yep., Thanks., You're, welcome., I'm gonna follow you and make a video of your dirty garbage mess., Oh, gosh.

Look at my mess!, Oh, geez, !, Oh, geez, what a gigantic mess first thing this morning.

When did you start doing that ? about five o'clock this morning? Yeah, my gosh.You stinker.


I just made a huge dirty.



You did I'm.

Pretty sure she's been awake since like, maybe the five o'clock hour, um, pulling cards out and that's.

Fine., I, don't, care., It kept her busy busy and distracted.

And um, I don't need all the licking.


Anyway, um I'm gonna document our morning how it goes.

Um, we've got to leave here around eight o'clock this morning to get to our appointment, maybe a few minutes earlier than that probably need to leave 7 50.

and then we're going to go to get donuts on the way home and I'm, not sure what else I don't know if we'll make it to any other stores or not we'll just have to go with the flow.

Alright., It's, 8 28.

And we have made it to the building.

But we're, not late, which is amazing.

So, let's.

Go on in get checked in okay? okay.

Okay, We're at our appointment.

That's, not really..., Where, we're, waiting on her appointment.

And while we're waiting we're going to look at houses that are for sale.


right?, Right., okay?, mama...

Those are big dogs, it's like what's.

Your other one's name.

Uh, nori, is it a big one or a little one?, no it's a little one what's, your big, one's name, grizzly., drizzly?, grizzly., mhm.

When are you gonna see him whenever I go home? Do you have any dogs? Yes, I.


You do?.

I did have a dog named abigail, but I had to have her put down.


She got to where she couldn't walk oh, bless her.

And um, it made me really upset.

So I'm just gonna have to have her put down.

And I got a new dog.

So everything's, good good, I'm glad to hear that., yeah., Alright, we're through with our clinic.


We've come down for some x-rays.

Do you understand what the x-rays are for?? No? Can you try to explain it I'm nervous? And I don't want them to do it because I'm afraid that there could be something wrong.

Yeah, but that's...

We got to know if something's wrong.

that's how we know if we need some to fix something, or if it's just uncomfortable because it's there., would I have my shunt taken out? if something's wrong with it, and they need to fix it.

They might take one out and put another one back in.

We just have to wait and see what we'll find out we're.

Gonna do a shot series, three x-rays, no, no, no, no, no that's, too many, too many, too much it's.

Not it's gonna be okay, no that's way, too much way, too much I'm, not gonna let them do it that many because that's too many want me to show you where the x-ray is going to be?.

Yeah, they're going to x-ray this and your belly where the tubing goes down.

So it's kind of like one, two three I was pretty nervous, but ..

we're all finished.


All finished.


Step down, right there.


So we had a good visit.

Jessica got an x-ray series., um, they're, checking her shunt tubing to see if it's pulled apart, or if it's kinked up or anything., We don't have to stay and wait on the results.

They're gonna give us a call later and let us know.

And then in a few weeks, or whenever we get it, scheduled, jessica's gonna have an MRI.

What is MRI? it's like a cat scan, it's like a ct scan, um, just to look for any changes or anything.

She hasn't had an mri in a long time like when she was little bitty, maybe five or six so that'll, be good.

So now we're off to do whatever the heck we wanna do isn't that right?.

Yeah, I thought we were gonna look at more houses when we get home.

We can either go straight home and look at houses, or we can go do something on the way home.

I wanna go do something on the way home.


So if you don't want donuts, we can pick up donuts to take home to have later, or we can plan on having, um strawberry shortcake at home later.

I want donuts for later, alright., what kind of donut? Do you want? Um, um.

Krispy kreme alright., instead of dunkin?, yeah, okey, dokey, okie, dokie, jessica.

How are you feeling now that it's all over I'm feeling? Okay, it made you real nervous.


I was pretty nervous.

And I was very later today in a little while can we still look at more houses?, yes., hmm.

What kind do you want?? Glazed?, maglazed, six, glazed, three, blueberry, cakes, and one.

I mean, three chocolate iced, dad, what's in the box?, the box? what's in that box?, tell me., donuts., alright! yeah.

Why did you get donuts?? Because I was good just because?, yeah, that's, just what I She thought about not being good.

And we were going to get donuts anyway, but she tried hard.


Good job.


You want to tell them what kind of donuts are in here? uh.

Well, yeah, hold on hold on just a minute.

Um, we've got uh.

We got what kind are these?, Six, six, six, glazed.

And what other kind? three..., three, blueberry cake, doughnuts blueberry cake doughnuts and three chocolate covered.

Donuts, three chocolate, covered donuts.

I want the blueberry glazed.

One can I have one? there's only like six yeah, there's enough donuts to share with Dad.

Hannah specifically asked for cake doughnuts.

that's, the kind she wants? No.

These are the cake doughnuts.

But I mean, she doesn't need all three of them who doesn't need them?.

Hannah, doesn't need all three of them?.

Dad can have one.

You like the maglazed anyway., Yeah., Yeah.

Alright, dad said, he could go get lunch.


Would you go? Get it for me?? Yes, I, will., thanks.

I bet you could even ride with him if you wanted to yeah, I think, yeah, I think I will mom.

Can you watch them for just? Yeah, yeah.

Just a minute.

Hey, daddy.

I have texted Marlow and told her that, um, I'm going to, um, uh that she could just come on over after.

She puts her that thing in the oven that she's doing and she's just she's, just gonna go ahead and head out.


I told her that she didn't have to wait until after my nap, she can just come on over.

Okay, that'll be good work for the rest of the day does that sound? Good gosh, Marlow, Partin, hey, jess.

Do you want to tell the camera? Uh, update the camera about your doctor visit and what what? Dr junior.

Said?, yeah.

Okay, camera's going.


Dr, junior said, that..., He, didn't say, I had to have anything fixed?, right, but.

But he said, if I do, he would be happy to fix it mhm.

So what did they do to check on it?? Um, they did shunt series., that's right, which is a series of x-rays.


and we'll get the results later and.

What are you going to have in a few weeks? in a few weeks? I'm gonna have a MRI that's, right? But that's not surgery.

No that's, just where you lay on the table and take a short little nap while they take pictures of your brain, and they look to make sure nothing's changing.

Did you tell? Dr junior where it was bothering you?, yes, show the camera where it's bothering you look.

it's, not bothering me right now right? But sometimes it bothers you there, and where else does it bother you, um, like right? There.

Mhm., let's, talk about the symptoms that you've been having.

One of the symptoms is that pain in your chest.

Yes, one of the symptoms is the pain behind your ear.

One of the symptoms is - does it hurt to turn your head, a certain way, ?, um, not no.


If I when you're getting your x-rays, she said, can you turn your head that way ?? And you said, no, why can't you turn your head that way?? Because it hurts me to do that? So it hurts you to turn your head?.

And what did you complain about all the way? Home?? I don't remember know, uh had a headache.

Yep, you kept saying, mama, my head hurts.

Why do I have a headache?? You've been having a headache every day that's, a symptom.

...Or presents.

You better believe it.

And you better, if you keep saying good, what happens? Then you bring some more of my presents over here.

If you say, bad, what happens? less presents that's right? But if but if we say, good, we get More presents, but if you say bad, but if you say, if you say, bad, you don't, get them.

that's right.

Can you say bye? Bye.


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.

What is the most common complication of VP shunt? ›

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.

What are the symptoms of overdrainage of a shunt? ›

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.

What is the life expectancy of someone with a shunt? ›

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

How common is shunt failure? ›

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.

Can a shunt get clogged? ›

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.

What is the most common cause of shunt failure? ›

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

What is the second most common cause of shunt malfunction? ›

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.

How often should a shunt be checked? ›

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.

What should you avoid with a VP shunt? ›

However, people with LP shunts should avoid any activity which involves twisting at the waist, as this can dislodge the shunt.
  • Martial arts. Any activity that involves being grabbed around the neck is not advised, as the shunt tubing in the neck can crack. ...
  • Rugby. ...
  • Gymnastics and dance. ...
  • Water sports. ...
  • Golf. ...
  • Other activities.

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].

What does a shunt malfunction look like? ›

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.

Can you live a long life with brain shunt? ›

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.

Who is the longest living person with hydrocephalus? ›

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.

Is a shunt major surgery? ›

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.

How many times can a shunt be replaced? ›

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.

Can shunt malfunction cause death? ›

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.

Can a shunt burst? ›

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.

Can a shunt cause a stroke? ›

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).

When should a shunt be removed? ›

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.

How do I know if my shunt is infected? ›

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.

How common is shunt revision? ›

Shunt revisions

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

How does a shunt become infected? ›

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

What are the symptoms of a shunt blockage in adults? ›

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.

What is the life expectancy of someone with hydrocephalus? ›

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.

What are the symptoms of death from hydrocephalus? ›

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.

Can you fly with a shunt in your brain? ›

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.

How long does a tube shunt last? ›

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.

Can you drive with a shunt in your head? ›

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.

Is a heart shunt serious? ›

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).

Is VP shunt a high risk surgery? ›

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 considered a disability? ›

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.

What does a shunt malfunction headache feel like? ›

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.

What makes hydrocephalus worse? ›

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.

Can shunt surgery cause memory loss? ›

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.

Does hydrocephalus affect intelligence? ›

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

What celebrity has hydrocephalus? ›

“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.”

Is hydrocephalus a form of dementia? ›

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.

What are the 2 types of shunts? ›

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.

Do they shave your head for shunt surgery? ›

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 of shunt surgery? ›

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.

How do I know if my brain shunt is working? ›

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.

What should you avoid with a shunt? ›

However, people with LP shunts should avoid any activity which involves twisting at the waist, as this can dislodge the shunt.
  • Martial arts. Any activity that involves being grabbed around the neck is not advised, as the shunt tubing in the neck can crack. ...
  • Rugby. ...
  • Gymnastics and dance. ...
  • Water sports. ...
  • Golf. ...
  • Other activities.

Can a shunt malfunction cause a stroke? ›

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).

Can a shunt in your head move? ›

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

What is the most common site for shunt obstruction? ›

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].

Who has the longest lifespan with hydrocephalus? ›

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.

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