Post-Operative Overdrainage in Ventriculoperitoneal Shunt Surgery

Q: Post-Operative Overdrainage in Ventriculoperitoneal Shunt Surgery

Hello： There is a possibility of excessive drainage with ventricular-peritoneal shunting (though it is rare). <br>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). <br

Is there a risk of excessive drainage after ventricular-peritoneal 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 drainage with no fluid in the ventricles.
We are unsure why this is happening.
Could it be due to a malfunction of the pump device that was implanted in his brain, causing the excessive drainage? Is it necessary to urgently perform surgery to replace the drainage system? Additionally, I would like to ask whether we should return to the original doctor for a follow-up or if it would be acceptable to consult another doctor who is also competent.
The doctors at National Taiwan University Hospital are quite busy, and their attitude and quality of service have not been very satisfactory.

Xiao Mi, 40~49 year old female. Ask Date: 2005/02/24

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 best to return to National Taiwan University Hospital, as the physician there is more familiar with your father's condition.
Thank you!

Reply Date: 2005/02/24

More Info

Post-operative overdrainage in ventriculoperitoneal (VP) shunt surgery is a significant concern, especially in patients who have undergone such procedures for conditions like hydrocephalus. Your father's situation, where a CT scan shows that the ventricles are devoid of cerebrospinal fluid (CSF), indicates that the shunt may be draining too much fluid. This can lead to a condition known as "subdural hematoma," where blood collects between the layers of tissue covering the brain, or "ventricular collapse," which can cause neurological symptoms.

The malfunction of the pump or valve in the VP shunt system could indeed be a contributing factor to the overdrainage. Shunt systems are designed to regulate the flow of CSF from the ventricles to the peritoneal cavity, and if the valve is set too low or if there is a blockage or malfunction, it can lead to excessive drainage. Symptoms of overdrainage may include headaches, dizziness, and changes in mental status, which could explain the dementia-like symptoms your father is experiencing.

In terms of urgency, if your father is showing signs of neurological decline or if there are concerns about the integrity of the shunt system, it is crucial to consult a neurosurgeon promptly. The need for surgical intervention to either adjust the shunt or replace it will depend on a thorough evaluation by a medical professional. If the shunt is indeed malfunctioning, it may require immediate attention to prevent further complications.

Regarding whether to return to the original surgeon or seek another opinion, both options are valid. If you feel that the original surgeon at National Taiwan University Hospital is too busy or not providing the level of care you expect, seeking a second opinion from another qualified neurosurgeon could be beneficial. It's essential to find a physician who is attentive to your father's needs and can provide a thorough evaluation and treatment plan.
When consulting with a new surgeon, make sure to bring all relevant medical records, including the CT scan results and any previous surgical notes. This information will help the new physician understand your father's medical history and the specifics of the shunt placement.

In summary, overdrainage of CSF in a VP shunt can lead to serious complications, and it is essential to address this issue promptly. Whether you choose to return to the original surgeon or seek a new one, ensure that your father's condition is evaluated as soon as possible to prevent further neurological decline.

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