VP Shunts

What Is a VP Shunt?

A ventriculoperitoneal (VP) shunt is a thin plastic tube that helps drain extra cerebrospinal fluid (CSF) from the brain. CSF is the saltwater that surrounds and cushions the brain and spinal cord.

Why Are VP Shunts Placed?

VP shunts are placed to treat hydrocephalus. Hydrocephalus (hi-droh-SEF-eh-less) happens when CSF does not drain out of the hollow spaces inside the brain (called ventricles) as it should. VP shunts drain the extra fluid and help prevent pressure from getting too high in the brain.

How Do VP Shunts Work?

Most shunts have two catheters (small, thin tubes) connected by a valve. One end of the upstream is in a ventricle. The other end of the downstream catheter is in the peritoneal (pair-et-NEE-ul) cavity. This is the space inside the belly where the stomach and the bowels are. The shunt is all inside the body, under the skin.

The valve opens when the pressure in the brain gets too high. This lets fluid drain from the brain into the peritoneal space. From there, the extra fluid is absorbed into the bloodstream.

How Should We Prepare for a VP Shunt?

Your child cannot eat or drink for several hours before the surgery. Tell the doctor about any medicines your child takes. Some might need to be stopped before the surgery. Also let the doctor know if your child has any allergies.

Your child should have clean hair (no grooming products) at the time of the surgery.

Your child will stay in the hospital after the surgery, so bring toiletries and other items that will help make the stay more comfortable.

What Happens During the Placement of a VP Shunt?

A surgeon will do the VP shunt placement in an operating room. 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.

Can I Stay With My Child During the Placement of a VP Shunt?

Parents cannot be in the operating room, but can wait nearby during the surgery.

What Happens After the Placement of a VP Shunt?

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.

The doctor will talk to you about:

• how long your child will stay in the hospital
• when your child can eat and drink
• taking any medicines at home, including pain medicines
• when your child can bathe
• how to take care of the surgical site area
• when your child can return to school, regular activities, and sports
• when your child can use a hair dryer and hair products
• any other needed restrictions

Are There Any Risks From VP Shunts?

VP shunts are generally safe, but there are some risks during and after the surgery. There can be bleeding, or an infection can develop.

VP shunts do not work forever. When the shunt stops working:

• The child can have another buildup of fluid in the brain.
• Another surgery is needed to fix it.

Problems with a VP shunt happen even with regular care and at unpredictable times. The shunt can get worn out or move as a child grows.

A shunt also can get infected, which can be very serious. It's important for families to follow the surgeon's instructions for when to call and when to go to the ER. This way, treatment for an infected or worn-out shunt can start as soon as possible.

When Should We Call the Doctor?

Call the doctor right away if your child:

• has swelling, redness, or fluid leaking from where the shunt went in
• has a headache or stiff neck
• has a fever of 100.4°F (38.0°C) or higher
• has nausea or vomiting
• is confused, very sleepy, or especially cranky
• has a change in behavior, coordination, or balance
• has a change in vision or eye movements, or can't move the eyes upward
• is an infant and has a bulging soft spot
• has pain around the VP shunt or its tubing (although this does not mean that the shunt has stopped working)
• has a seizure