Shunts
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Explanation | Shunt malfunctions | Shunt revisions | What to Expect After
What is a shunt?
A shunt is a tube that drains the cerebrospinal fluid (CSF) from the ventricles in the brain to another space in the body, which reabsorbs the fluid. Most often the abdominal cavity (the space around the stomach and intestines) is used. The shunt's small, soft tubing is placed, or tunneled, under the skin and the end of the tubing is placed in the abdominal space. This is done in the operating room.
A valve is attached to the shunt tubing. It controls the direction the cerebrospinal fluid flows and keeps a normal amount of cerebrospinal fluid in the ventricles. The valve adjusts the amount of cerebrospinal fluid that flows from the ventricles and prevents the ventricles from over-draining, which is called over-shunting.
Shunt malfunctions
A shunt malfunctions when something blocks the flow of cerebrospinal fluid within the shunt. This may be caused by the buildup of the tissue, proteins and chemicals in the cerebrospinal fluid which clog the tubing. It may also be caused by tissue within the abdominal space which blocks the flow of the distal tubing. Additionally, over time the shunt tubing may wear out or pull apart, requiring it to be replaced.
The signs of a shunt malfunction are similar to the signs of hydrocephalus. The symptoms are a result of pressure again building up within the head. Your child's doctor needs to be notified immediately if and when these symptoms develop.
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Shunt revisions
When a shunt is not working well, all or part of it must be replaced. This is done in the operating room. Your child's neurosurgeon will decide where the problem is within the shunt system. He / she will then replace the tubing in the head (the proximal tubing), the tubing to the abdominal space (the distal tubing), and / or the valve.
Depending on where the blockage is, either proximal or distal, will determine where the surgeon needs to operate. If it is a blockage in the proximal system (valve or ventricular catheter) a small patch of hair will be shaved and a “C” shaped incision will be made.
If the blockage is a distal malfunction, there will be an abdominal incision. Sometimes it is unclear where the malfunction is occurring and so both the head and abdomen need to be explored.
What Should I Expect After the Procedure?
After the revision your child may resume his / her regular diet and activity as they feel ready.
- Dressings will come off after 24 hours
- You may wash the incision on day 2
- Sutures or staples will need to be removed in 7-10 days
- Your child may go home in 24 hours after the surgery if all discharge goals have been met
Rev. 6/09
