the Lifespan and Risks of Ventriculoperitoneal Shunt Systems

Dr. Chang, does the ventricular-peritoneal shunt system have a lifespan or can it become damaged?

Hello Dr.
Chang, my mother is currently 57 years old.
At the end of 2015, she underwent surgery for a cerebral hemorrhage at Linkou Chang Gung Memorial Hospital, where a cerebral aneurysm was clipped to remove the problematic blood vessel.
Due to the cerebral hemorrhage, she developed hydrocephalus and underwent a ventriculoperitoneal shunt placement, with an adjustable drainage system chosen.
Since my mother's cerebral hemorrhage was not severe, both the ventriculoperitoneal shunt surgery and the cerebral aneurysm surgery were considered successful.
After a year of rehabilitation, my mother returned to normal work.
However, on July 2, 2017, while doing housework at home, my mother suddenly felt dizzy, weak in all four limbs, nauseous, and vomited.
She became so weak that she could not walk, so we took her to a nearby hospital for emergency care.
The emergency room doctor suggested that her symptoms might be due to vertigo and hyperventilation.
The CT scan and blood tests came back normal, and the doctor prescribed some medication for dizziness.
The next day, we returned to Linkou Chang Gung for a follow-up appointment.
The doctor asked us to bring the CT scan disc for review, stating that he needed to see it to confirm her condition.
However, over the next few days, my mother continued to experience headaches, dizziness, and vomiting, although the symptoms were not as severe.
In the discharge instructions provided by the nurse after the ventriculoperitoneal shunt surgery, it was mentioned that we should return to the emergency department if any of the following occurred: (1) gradual changes in consciousness such as drowsiness, confusion, or unresponsiveness; (2) worsening headaches or vomiting; (3) difficulty breathing; (4) seizures in the limbs or facial muscles.
I would like to ask Dr.
Chang if my mother's condition could possibly be due to a malfunction of the ventriculoperitoneal shunt system? If it is indeed malfunctioning, would she need to undergo another surgery to replace it? I have been unable to find relevant information online regarding damage to the ventriculoperitoneal shunt, so I am inquiring here.
Thank you.

Hao Shen, 30~39 year old female. Ask Date: 2017/07/11

Dr. Zhang Junwei reply Neurosurgery

Basically, the likelihood of damage to the ventricular-peritoneal shunt system is low, but there is a possibility of incorrect pressure or blockage.
Please visit the neurosurgery outpatient clinic for a physician evaluation.

Reply Date: 2017/07/11

More Info

Understanding the lifespan and risks associated with ventriculoperitoneal (VP) shunt systems is crucial for patients who have undergone procedures for conditions like hydrocephalus, particularly following complications such as brain hemorrhage. Your mother's medical history indicates that she has had a VP shunt placed after a successful brain aneurysm surgery, which is a common treatment for managing hydrocephalus.
VP shunts are designed to divert excess cerebrospinal fluid (CSF) from the ventricles of the brain to the peritoneal cavity, where it can be absorbed. While these devices can significantly improve the quality of life for patients, they are not without risks and complications. The lifespan of a VP shunt can vary, but on average, they may function effectively for several years. However, complications can arise, necessitating further medical intervention.

Common complications associated with VP shunts include:
1. Shunt Malfunction: This can occur due to blockage, kinking, or disconnection of the shunt system. Symptoms of malfunction may include headaches, nausea, vomiting, changes in consciousness, and neurological deficits. Given your mother's symptoms of dizziness, weakness, and vomiting, it is plausible that her VP shunt may not be functioning optimally.

2. Infection: Shunt infections can occur, leading to symptoms such as fever, redness along the shunt tract, and worsening neurological symptoms. Infections may require antibiotic treatment and sometimes surgical intervention to remove and replace the shunt.

3. Over-drainage or Under-drainage: If the shunt drains too much CSF, it can lead to a condition called "slit ventricle syndrome," where the ventricles become too small. Conversely, under-drainage can lead to increased intracranial pressure, causing headaches and other symptoms.

4. Peritoneal Complications: Since the shunt drains into the abdominal cavity, complications such as abdominal pain, infection, or fluid accumulation can occur.

In your mother's case, the symptoms she is experiencing could indeed suggest a malfunction of the VP shunt. The fact that her CT scan and blood tests returned normal results is reassuring, but it does not rule out shunt-related issues. If the shunt is suspected to be malfunctioning, further imaging studies, such as a shunt series X-ray or ultrasound, may be warranted to assess the integrity and function of the shunt.

If it is confirmed that the VP shunt is malfunctioning, surgical intervention may be necessary. This could involve either repairing the existing shunt or replacing it entirely, depending on the nature of the problem. It is essential to consult with a neurosurgeon who can evaluate your mother's condition and recommend the appropriate course of action.

In summary, while VP shunts can provide significant benefits, they require careful monitoring for potential complications. Given your mother's symptoms, it is crucial to seek prompt medical attention to determine the status of her VP shunt and address any issues that may arise. Regular follow-ups with her healthcare provider are essential to ensure her ongoing health and well-being.

Similar Q&A

Can Children with Ventriculoperitoneal Shunts Jump Rope Safely?

The child is currently 8 years old and previously exhibited symptoms of hydrocephalus, for which a ventriculoperitoneal shunt was placed. Is it safe for them to engage in activities similar to jump rope?

Dr. Zhang Junwei reply Neurosurgery
This cannot be determined; you need to ask the surgeon who performed the operation at that time.

Post-Operative Care for Ventriculoperitoneal Shunt Surgery: FAQs

Hello, doctor. I have undergone ventriculoperitoneal shunt surgery, and since the catheter passes through my neck, I would like to ask if turning my head or frequently shaking my head in daily life could cause the catheter to displace or break. Thank you.

Dr. Jiang Junyi reply Neurology
Hello: Ventriculoperitoneal shunt surgery is performed when there is an excessive production of cerebrospinal fluid or when the pathways are obstructed, leading to an accumulation of cerebrospinal fluid in the brain, resulting in hydrocephalus. This shunt surgery diverts the cere...

Post-Operative Overdrainage in Ventriculoperitoneal Shunt Surgery

Hello Doctor: My father underwent a ventriculoperitoneal shunt surgery at National Taiwan University Hospital over a year ago due to a diagnosis of hydrocephalus. Recently, he exhibited symptoms similar to dementia and went to Renai Hospital for a CT scan, which showed excessive ...

Dr. Qiu Yushu reply Neurosurgery
Hello: There is a possibility of excessive drainage with ventricular-peritoneal shunting (though it is rare). It is advisable to replace it with a drainage device that has a different (higher) pressure setting (there are three types of external drainage device pressures). It is b...

Essential Care Tips for Patients with Permanent Ventricular Drainage

Hello Dr. Chang, my friend had a car accident three years ago, which resulted in a brain injury that prevented the absorption of cerebrospinal fluid. During the process, they experienced meningitis and cerebral edema. Two months later, a permanent ventricular shunt was placed, an...

Dr. Zhang Junwei reply Neurosurgery
1. No, there isn't. 2. It depends on the type of drainage tube you have installed.