Shunt - ventriculoperitoneal
Key points
- Ventriculoperitoneal shunt is surgery is performed to relieve intracranial pressure caused by hydrocephalus.
- This procedure is performed in the operating room under general anesthesia.
- In hydrocephalus, the ventricles of the brain become enlarged with cerebrospinal fluid.
- Common complications of VP shunt include shunt malfunction or blockage, infection.
Alternative names
Ventriculoperitoneal shunt; VP shunt
Definition
Ventriculoperitoneal shunt is surgery is performed to relieve intracranial pressure caused by hydrocephalus. The fluid is shunted from the ventricles of the brain into the abdominal cavity or in rare instances the pleural space in the chest.
Description
This procedure is performed in the operating room under general anesthesia. A flap is cut in the scalp and a small hole is drilled in the skull. A small catheter is passed into a ventricle of the brain.
A pump (valve which controls flow of fluid) is attached to the catheter to keep the fluid away from the brain. Another catheter is attached to the pump and tunneled under the skin, behind the ear, down the neck and chest and into the peritoneal cavity (abdominal cavity).
Indications
In hydrocephalus, the ventricles of the brain become enlarged with cerebrospinal fluid. This condition causes the brain tissue to become compressed against the skull, thus causing serious neurological problems. Shunting is necessary to drain the excess fluid and relieve the pressure in the brain. This should be done as soon as hydrocephalus is recognized to give the child the best possible neurological outlook.
In some cases hydrocephalus is secondary to another disease process affecting the brain. One example is an intracranial hemorrhage where blood gets into the ventricles of the brain and causes the fluid to not drain properly. In cases like this a shunt is necessary to assist in the fluid being removed to alleviate raised intracranial pressure.
RISKS
Risks for any anesthesia are:
- reactions to medications
- problems breathing
Risks for any surgery are:
- bleeding
- infection
Common complications of VP shunt include shunt malfunction or blockage, infection. Malfunction may be related to growth and the shunt will need to be replaced with a longer catheter. Symptoms of shunt malfunction or infection include headache, fever, drowsiness and convulsions.
As with any other brain surgery there is risk to actual brain tissue as the shunt catheter must pass through brain tissue to enter the ventricle. Thus a small but potential risk of brain tissue being damaged and resulting in a neurologic deficit exists.
Written and revised by
Gerald Hurowitz, M.D.
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