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VP Shunts

What Is a VP Shunt?

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

Why Are VP Shunts Placed?

VP shunts are placed to treat hydrocephalus (also called "water on the brain"). Hydrocephalus happens when CSF does not drain out of the brain as it should. When CSF pools in the brain, it can make babies' and young children's heads swell to make room for the excess fluid. Older kids, whose skull bones have matured and fused together, can have painful headaches or other symptoms from the increased pressure.

First diagram is before shunt with extra CSF in the ventricles and shows brain,
            ventricles, and increased pressure in the ventricles. Second diagram is after shunt
            with less CSF in the ventricles and shows the shunt in the ventricles

How Do VP Shunts Work?

CSF can build up in the brain if the fluid does not drain out of the brain as it should. A VP shunt can drain extra fluid and help prevent pressure from getting too high in the brain.

Most shunts have two catheters (small, thin tubes) and a valve. The tip of one is in the brain, with the other end attached to a valve. The valve opens when the pressure in the brain gets too high. This allows fluid to drain through the shunt down into the peritoneal space, which is in the belly. From there, the extra fluid can be absorbed into the bloodstream and filtered out in the kidneys. Then the body can pee out the extra fluid.

The brain continues to make new CSF all the time, so the VP shunt must be able to drain any extra fluid that builds up.

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 the stay be comfortable.

What Happens During the Placement of a VP Shunt?

VP shunts are placed in the operating room. Your child will get anesthesia to make him or her sleep during the surgery. 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 in the brain. This catheter is connected to a valve, which is then connected to a second catheter. Incisions also might be made in the neck and abdomen to help get the shunt in the best position.

When the shunt is in place, the doctor closes the incisions with stiches or staples, and puts on bandages. You will not be able to see the VP shunt, but you may be able to feel where the tubing travels 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 is done, your child will be closely watched. 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
  • pain medicines
  • continuing any medicines your child was on before the procedure
  • when your child can bathe
  • when the bandages will be removed, and when any stiches or staples will come out
  • when your child can return to school, regular activities, and sports
  • when your child can use a hair dryer and hair products
  • any other necessary 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. The VP shunt can also malfunction. If this happens, a child can have a buildup of fluid in the brain again.

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
  • 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
  • has a seizure