Ventricular Shunt for Hydrocephalus

Hydrocephalus (hydro-water, Cephalus-head) is an increase of cerebral spinal fluid (CSF) in the brain. This can be caused by problems with how the CSF is made, circulated, or absorbed. When CSF collects in the brain, the ventricles get bigger (see image 1 on last page). This makes pressure in the head increase, causing sickness.

Symptoms
Symptoms vary with age, and may include:

• Headache

• Vomiting

• Irritability

• Decreased appetite

• Fatigue

• Increased head size in infants

• “Sunset eyes” (eyes which do not look up)

• Blurred or double vision

• Clumsiness in older kids and adults
  

Treatment
To reduce pressure on the brain, the CSF must be drained. One way to do this is to place a shunt. A shunt is a soft, narrow piece of tubing that drains the extra CSF from the brain to the abdomen or the space around the heart or lungs. Once the shunt is placed, the CSF is absorbed by the body (see image 1 on last page).

Before Surgery
You will have a physical exam and lab tests that include blood work and urinalysis. Schedule this exam with your primary care provider or with a nurse in our department. Complete this within 30 days of surgery. We may cancel surgery without an updated exam. Contact your insurer if you need a referral.

Stop these medicines for two weeks before surgery:

• Aspirin, Excedrin®, Ascriptin®, and Ecotrin®

• Vitamins and herbal supplements

• Plavix®

• Coumadin® or warfarin

• Ibuprofen, Advil®, Motrin®, Nuprin®, and Aleve®

• You may use acetaminophen (Tylenol®) if needed
  

Avoid smoking and secondhand smoke for two weeks before surgery. Smoking delays wound healing.

You will be called the afternoon before surgery. You will be told what time you need to arrive and details about how to get ready.

During Surgery
A small hole will be made through the skull. Tubing will be placed through the hole into the brain. A one-way valve will be attached to the catheter and placed under the scalp. A small cut will be made where the catheter ends. This will take about two hours.

After Surgery
You will spend at least one night in the hospital. Once you are eating and drinking and there are no other concerns, you will be ready to go home.
You may have two bandages in place. One will be on your head and one on your torso. The bandages may stay in place until your follow-up clinic visit. Your bandages should remain clean and dry.

After discharge, you may resume your normal routine. You will need a regular follow up with a neurosurgeon and MRI scans to check the size of your ventricles.

When to Call
A shunt may not work if it becomes clogged, disconnected, or infected. Call right away if you notice any of these symptoms:

• Redness, pain or swelling of the skin along the length of the shunt, or at the incision sites.

• Drainage from the incision.

• Fever over 101.5F within the first six months of surgery.

• Any symptoms of hydrocephalus
  

Who to Call
American Family Children’s Hospital Clinic (608) 263-6420

After hours, weekends, and holidays, call the paging operator at (608) 262-0486. Ask for the neurosurgeon on call. Give your name and phone number with the area code. The doctor will call you back. If you live out of the area, call 1-800-323-8942.