Ventriculoperitoneal Shunt Placement Brain Surgery

Candidates for a Ventriculoperitoneal Shunt Placement

Placing a Ventriculoperitoneal Shunt is a surgical procedure that treats hydrocephalus, which is a condition that occurs when excess cerebrospinal fluid builds up in the ventricles of the brain. Cerebrospinal fluid acts as a cushion between the brain and the skull and delivers vital nutrients to the brain while also washing away waste. The fluid flows through the ventricles to the brain stem, cleansing the brain and spinal cord before it is reabsorbed into the blood.

When cerebrospinal fluid collects in the ventricles, it disrupts the flow and creates pressure within the skull that presses against the brain. This pressure can be harmful to the brain tissue. A surgeon will perform a Ventriculoperitoneal Shunt Placement to surgically place a shunt within the ventricle, diverting the cerebrospinal fluid away from the brain and restoring its normal flow.

What is a Ventriculoperitoneal Shunt Placement?

During a Ventriculoperitoneal Shunt Placement procedure, the surgeon places a medical device called a shunt, which is a small hole or passage, in the ventricle to relieve pressure caused by fluid build-up. A ventriculoperitoneal shunt is used to treat hydrocephalus wherein cerebrospinal fluid builds up in the ventricles, expanding the affected area and causing damage that may lead to symptoms of mild dementia, cognitive delays, shuffled gait or incontinence.

The patient is placed under general anesthesia for the procedure, which usually takes around 90 minutes. The area behind the patient’s ear is shaved prior to surgery so that the surgeon may place the catheter here. Then, a small incision is made behind the ear and the surgeon drills a small hole in the skull. The catheter, which is a small plastic tube that will drain the excess cerebrospinal fluid, is placed through this hole and into the brain. Another catheter is threaded under the patient’s skin behind the ear, traveling down to the chest and abdomen. Excess fluid will be deposited here, where it can be absorbed into the body.

A pump may also be attached to both catheters, which will activate when pressure builds up in the skull and work to drain the excess fluid. Some pumps or valves can also be programmed to activate at a certain level of fluid build-up.

Results of a Ventriculoperitoneal Shunt Placement

The shunt will remain in the patient and the surgeon and medical staff will ensure it is working properly before the patient is discharged. The recovery period from a Ventriculoperitoneal Shunt Placement is typically three to four days and most patients are able to leave the hospital within a week of the surgery. Before being discharged, the patient’s heart rate and blood pressure are monitored and proper function of the shunt is confirmed. Preventative antibiotics are administered to ward off infection from surgery.

Shunting is generally an effective treatment of hydrocephalus and is successful in draining excess cerebrospinal fluid to reduce pressure within the skull. The shunt may require replacement after several years and should be monitored frequently.

What are the risks of a Ventriculoperitoneal Shunt Placement?

As with any surgical procedure, risks include excessive bleeding, infection, adverse reaction to anesthesia, changes in heart rate, blood pressure or difficulty breathing. Risks specific to a Ventriculoperitoneal Shunt Placement are infection in the shunt or brain, blood clots, brain bleeds, damage to brain tissue or swelling of the brain. The shunt could also be ineffective in treating the patient’s symptoms or may malfunction.

If the shunt does malfunction, complications could include over or under-draining of the cerebrospinal fluid. This could cause the ventricles to collapse and is a serious risk that may lead to headaches or hemorrhaging in the brain.

Fever, headache, abdominal pain, fatigue and a spike in blood pressure could indicate an infection. An infection is reportedly most common within the first few weeks following a Ventriculoperitoneal Shunt Placement.