Treatment of Hydrocephalus*
Implanting a Shunt System
Implanting of a shunt system is a relatively short surgical procedure. The procedure is performed in an operating room using sterile techniques under general anesthesia. A neurosurgeon will perform the procedure where he or she will make an incision on the scalp and a small hole made in the skull. This hole will allow access to the ventricle where the catheter will be placed. This catheter will be connected to the valve, which will allow the CSF to drain away from the brain. Lastly, another small incision is made in the abdomen to pass the end of the catheter into the abdominal cavity. Once all of the connections are made, the shunt system will automatically open to drain excess CSF whenever the pressure in the skull exceeds the opening pressure set on the valve.
Potential Complications of a Shunt System
Shunt systems are not perfect devices. Complications may include mechanical failure, infections, obstructions and the need to lengthen or replace the catheter. Generally, shunt systems require monitoring and regular medical follow up. When complications do occur, usually the shunt system will require some type of revision.
Over-draining of Cerebrospinal Fluid
Some complications can lead to other problems, such as over-draining or under-draining. Over-draining occurs when the shunt allows CSF to drain from the ventricles more quickly than it is produced. This over draining can cause the ventricles to collapse, tearing blood vessels and causing headache, hemorrhage (subdural hematoma), or slit-like ventricles (slit ventricle syndrome).
Under-draining of Cerebrospinal Fluid
Under-draining occurs when CSF is not removed quickly enough and the symptoms of hydrocephalus recur. In addition to the common symptoms of hydrocephalus, infections from a shunt may also produce symptoms such as a low-grade fever, soreness of the neck or shoulder muscles, and redness or tenderness along the shunt tract. When there is reason to suspect that a shunt system is not functioning properly (for example, if the symptoms of hydrocephalus return), medical attention should be sought immediately.
* Information provided by the National Institute of Neurological Disorders and Stroke (NINDS).