Hydrocephalus Shunt Procedures

What Is It?

A hydrocephalus shunt procedure is one of the most common treatments for various forms of hydrocephalus. Because hydrocephalus results from the inadequate flow and absorption of cerebrospinal fluid in and around the brain and spinal cord, the most effective treatment is to help re-direct the flow and absorption of this fluid.

On a short term basis, external drainage of cerebrospinal fluid through a ventriculostomy catheter can be done to remove pressure inside the head. This is often done in cases of hospitalization for acute hydrocephalus or after traumatic brain injury. However, having a catheter coming outside of the head is obviously not a good long term solution.

For the long term treatment of chronic hydrocephalus an internal drainage is often created surgically. There are more than one way to accomplish this but the most common hydrocephalus shunt is what is called a ventriculoperitoneal shunt, or VP shunt for short. This is a catheter which is placed inside the ventricles (the fluid-filled spaces within the brain) and is attached to a valve which limits the amount and direction of flow of the fluid. This valve is then connected to a long catheter that is tunneled under the skin from the head down to the abdomen where it ends in the abdominal cavity (the peritoneum). This type of hydrocephalus shunt diverts the excess fluid from inside the ventricles in the brain to the abdomen where it can be re-absorbed.

Shunt procedures leave an implanted catheter and valve in the patient chronically. Because of this, these can be prone to infection, particularly shortly after surgery. Also, because it is a mechanical device and catheter, they can be prone to blockage and malfunction. Some shunts get clogged after some amount of time and require surgical revision or replacement.

Other types of shunt procedures include shunts which drain the fluid to other areas such as a ventriculopleural shunt (drains to the chest cavity around the lungs) or a ventriculoatrial shunt (drains into the bloodstream directly by way of a catheter in a large vein and into the right side of the heart). Another form of shunt is a lumboperitoneal shunt which drains fluid from the spinal canal in the lower back into the abominal cavity.

Finally, a newer option for some forms of hydrocephalus is a treatment called an endoscopic third ventriculostomy. This is favorable in some situations because no shunt catheter and value are left implanted in the patient. Instead, an internal shunt between the ventricles and the space outside the brain is created to internally divert the flow of cerebrospinal fluid.

What Is It Typically Used For?

All of these various treatment options vary in their application and uses. Each patient should discuss the most appropriate treatment options with their own treating physician.

Generally, a standard ventriculoperitoneal shunt (VP shunt) is the most commonly used hydrocephalus shunt for most forms and causes of hydrocephalus, both pediatric and adult.

Other forms, such as ventriculopleural shunts, ventriculoatrial shunts, lumbosacral shunts and endoscopic third ventriculostomy, all vary in their application depending on the specific type of hydrocephalus and other factors such as anatomic features of the patient and prior treatment and complications.

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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