Follow-up visits will help the doctor ensure that the shunt is functioning properly and continuing to relieve hydrocephalus symptoms. In addition, the care team may recommend physical therapy, occupational therapy and other rehabilitation strategies to help resolve symptoms as soon as possible.
Hydrocephalus symptoms may improve within days of shunt surgery, or may take weeks to months to get better. Other neurological or medical conditions can affect recovery. If your symptoms are mostly due to normal pressure hydrocephalus as opposed to other conditions, the shunt is likely to help alleviate them. About 10 percent of patients show some improvement soon after a shunt is placed, but show less of a long-term response.
The reasons for this are not well understood. Shunts can be programmable externally adjustable by a magnetic device or non-programmable. Most surgeons will choose a programmable model, despite the fact that in clinical trials, both types perform comparably. Likewise, there are various manufacturers of programmable shunts, none of which has been clinically proven to be more effective than others. To prevent over-drainage the surgeon may implant an anti-siphon device along with your shunt, which helps to prevent over-drainage in an upright position.
Anti-siphon devices come in a range of strengths for your surgeon to choose from. In general, a higher shunt setting means less fluid is being drained. A lower setting means more fluid is being drained. There are a variety of valves, but all of them work to control the amount of CSF drained.
Valves are either set to a fixed pressure or they can be adjustable , also referred to as programmable , from outside the body.
Fixed pressure valves drain to a defined intracranial pressure. Fixed pressure valves regulate the pressure within the brain using a one-way valve at a predetermined pressure setting.
When open, the valve allows CSF to flow away from the brain. Most commercially available fixed pressure valves have three to five possible settings: low, medium or high pressures and very low and very high.
Once implanted, the pressure setting cannot be changed without additional surgery. Adjustable programmable valves regulate the ICP based on a pressure setting, like the fixed pressure valve, but the setting can be adjusted by your doctor using an external adjustment tool applied outside the body if there needs to be a change in how much CSF is draining.
This allows your health care professional to non-invasively change or program the valve pressure setting during an office visit. The number of available settings depends on the valve model and manufacturer. These valves are designed to be adjusted by a strong magnetic field found in the external adjustment tool. Some of these valves may be susceptible to adjustment by strong environmental magnetic fields and care must be taken to keep toys with magnets and other sources of magnetic fields away from the implanted device.
Some adjustable valves incorporate mechanisms that cannot be adjusted by magnetic fields other than those produced by the programmer. Many shunt systems also have a reservoir located under the skin between the inflow proximal catheter and the valve. The reservoir serves several important functions. It can be used to remove samples of CSF for testing, your doctor can inject fluid into the system to test the flow and function of the shunt, and it can be used to measure pressure.
In addition, the reservoir can be felt through the skin and pumped manually to help keep the proximal catheter open. In general, if one pushes on the reservoir and it does not spring back, then there might be an obstruction in the proximal catheter because the reservoir is not filling with CSF. You should not pump your reservoir unless explicitly instructed to do so by your doctor.
This results in over-drainage of CSF from the brain. Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week. Resource No: FS Updated: January All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Research and education. Back to fact sheets. Shunt surgery fact sheet. Shunt surgery. What type of shunt will my child have? Why does my child need a shunt? What happens before the operation?
What happens after the operation? Immediately after the operation, your child will either go to our intensive care unit, or direct back to the ward for close observations.
When your child has been returned to the ward, nurses will closely observe them for the first 24 hours. Your child will get anesthesia to sleep during the surgery and not feel pain. A small area of hair might be shaved, then the surgeon will make small incisions cuts in the scalp. After making a small hole in the skull, the surgeon will place the tip of the catheter into the brain.
This catheter is connected to a valve, which is then connected to a second catheter. When the shunt is in place, the doctor closes the incisions with stitches or staples, and puts on bandages. The catheter runs under the skin into the belly, so you can't see it. You might be able to feel where the tubing travels under the skin in the neck.
After the surgery, the doctors and nurses will watch your child closely in the recovery room. Your child will have bandages on the incision sites. VP shunts are generally safe, but there are some risks during and after the surgery. There can be bleeding, or an infection can develop.
Problems with a VP shunt happen even with regular care and at unpredictable times.
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