Cerebrospinal Fluid Shunt

Cerebrospinal Fluid (CSF) Shunt Surgery is a procedure to drain excess cerebrospinal fluid (CSF) collected in the brain’s ventricles and relieve pressure on the brain due to fluid accumulation. The procedure is performed when there is too much pressure in the brain caused due to CSF accumulation, a medical condition called hydrocephalus. It mostly occurs in babies and older adults. Normally, CSF flows through the ventricles of the brain, thereby immersing the brain and spinal cord in it and eventually gets absorbed in the blood. When this normal flow is disrupted, it causes fluid accumulation and puts harmful pressure on brain tissues. CSF Shunt drains fluid from the brain to other parts of the body where the fluid is absorbed. Cerebrospinal Fluid Shunt Surgery is also called Ventriculoperitoneal Shunt or VP Shunt.

INDICATIONS
The surgery is recommended to patients with swelling, cysts, tumors, or inflammation in the brain due to excess buildup of cerebrospinal fluid. Excess fluid occurs mainly due to

  • Excess production of CSF
  • Inability of blood vessels to absorb the fluid
  • Blockages that restrict the flow of the fluid
  • ommon indications include visible increase in the size of head, frequent headaches and seizures, poor appetite, loss in memory and poor co-ordination between thoughts and actions.

PRE-PROCEDURE
The surgeon will instruct to

  • Conduct imaging tests of the brain like CT Scan and MRI to determine the exact location of excess fluid
  • Stop blood thinners, at least 10 days before the procedure
  • Fast for 6 hours prior to the procedure

DURING PROCEDURE
The procedure is performed under general anesthesia by an experienced neursurgeon, and generally takes around 90 minutes. During the surgery, the surgeon will

  • Put a small cut behind the ear and another in the belly, after administering the anasthesia.
  • Drill a small hole in the skull and pass a catheter into a ventricle of the brain.
  • Another catheter is placed under the skin behind the ear and is made to travel to the chest and abdomen.
  • A pump (valve) which is attached to both catheters is placed behind the ear.
  • When the pressure in the skull increases, this pump will help automatically remove the fluid into the belly area.

POST PROCEDURE
After the procedure is complete, the patient may be required to stay in the hospital to upto a week. The doctor and his team closely monitors the patient’s vitals. The patient is taught how to take care of the shunt at home and how to prevent any infection from developing. In babies, the shunt has to be replaced after 2 years while in older adults, it has to be replaced after 8 years.

RISK AND COMPLICATIONS

  • Cerebospinal Fluid Shunt Surgery might have the following risks and complications:
  • Leakage of the fluid under the skin
  • Bowel perforation (holes in the intestines)
  • Shunt blockage
  • Bleeding, swelling or blood clot in the brain
  • Malfunction of the shunt may cause fever, frequent headache, fatigue and infection.

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