VP SHUNT IMPLANT …. … it’s a lifetime thing — and about its Complication

VP Shunt

VP Shunt

courtesy of Children’s Healthcare of Atlanta

Complications

  • Obstruction
  • Infections
  • Shunts & Pregnancy
  • Other Complications

Although HC is almost always treated successfully with the surgical procedure of a shunt, shunt malfunction occurs in about 2 – 4% of cases. Shunt malfunction simply means that the shunt is not able to divert enough fluid away from the ventricles in the brain. Its two most common cases are obstruction of the shung and infection. These are serious problems and must be treated approprately. Most complications that require revision of the shunt occur within 6 months to 1 year after surgical placement of the shunt.


However, in my daughter’s particular implant, it was over 10 years before her first shunt malfunction, and it was due to growing up: height and weight are factors.

In thinking back, it may seems strange, but I contribute a lot to her shunt malfunctions to events of childhood activities. A rollercoaster ride at the carnival and even getting her first hair perm. Her tube had pulled loose from the bulb at its base. Call me crazy, but those two things I remember just before shunt malfunctions.


OBSTRUCTION – When shunt malfunction occurs, it is usually a problem with a partial or complete blockage of the shunt. The fluid backs up from the site of the obstruction and, if the blockage is not corrected, almost alawys results in a recurrent symptoms of hydrocephalus. Shunt obstruction can occur in any of the components of the shunt. Most commonly, the ventricular catheter becomes obstructed by tissue from the choroid plexus or bentricles. The catheters or the value may become blocked with blood cells or bacteria. Also, the tip of the pertioneal catheter may become obstructed by loops of the bowel or by fat tissue in the abdominal cavity.


INFECTIONS – Shunt infection usually is caused by a child’s own baterial organisms, and is not acquired from exposure to ther children or adults who are ill. The most common organism to produce infection is called Staphylococcus epidermidits, this is normally found on the surface of the child’s skin and in the sweat glands and hair follicles deep within the skin. Infections of this type are most likely to occur 1 month after surgery, but may occur up to 6 months after the placement of a shunt.

Children with VP shunts are most prone to abdominal infection, whereas children with VA shunts may develop generalized infection which can quickly become serious. In either case, the shunt infection must be treated immediately to avoid life threatening illness or possible brain damage.


OTHER COMPLICATIONS – In rare cases, other complications may develop with patients who receive shunts. Although they are unlikely to occur, described briefly for your information. Shunts are very durable, but there have been instances in which the components of the shunt have become disengaged as a result of the child’s growth and have moved within the body cavities where they originally were placed. Very rarely, a valve will fail because of mechanical malfunction. However, it is possible that the valve pressure for a child’s shunt system can drain fluid too rapidly or too slowly. To restore a balanced flow of fluid it may be necssary to replace the shunt with a new shunt containing a more appropriate pressure vale. Overdrainage of the ventricle could cause the ventricle to decrease in size to the point where the brain and its meminges pull away from the skull. If blood from broken vessels in the meninges becomes trapped between the brain and skull, resulting in a subdual hematoma, further surgery is required.

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