Add a header to begin generating the table of contents. What is a Shunt? A shunt consists of three major components: An inflow or proximal catheter, which drains CSF from the lateral ventricles.
This tube leaves the brain through a small hole drilled in the skull and then runs for a short distance under the skin. A valve mechanism, which regulates intracranial pressure by controlling fluid flow through the shunt tubing. This device is connected to the proximal catheter and lies between the skin and the skull, usually on top or the back of the head, or just behind the ear.
Valves operate within a specific pressure range. There are many types of valves and shunt manufacturers. An outflow or distal catheter, which runs under the skin and directs CSF from the valve to the abdominal peritoneal cavity, heart or another suitable drainage site. What are the most common shunt systems?
The most common shunt systems are: Ventriculoperitoneal VP shunts. This type of shunt diverts CSF from the ventricles of the brain into the peritoneal cavity, the space in the abdomen where the digestive organs are located. The tip of the distal catheter rests in this cavity near the loops of the intestine and bowel but not inside them. The CSF shunted to this area is reabsorbed into the bloodstream and is eventually excreted through normal urination.
Ventriculoatrial VA shunts. This type of shunt diverts CSF from the ventricles of the brain into the right atrium of the heart. The distal catheter is placed into a vein in the neck and then gently advanced through the vein into the right atrium of the heart. Here the CSF passes directly into the bloodstream and subsequently excreted through normal urination. Ventriculopleural VPL shunts. This type of shunt diverts the CSF from the ventricles of the brain into the pleural chest cavity.
This cavity is a space between the chest wall and the lungs. It is lined by a membrane along the chest wall parietal pleura membrane and the lung surface visceral pleura membrane with pleural fluid in between. The CSF is added to this fluid and is absorbed and subsequently excreted through normal urination. Lumboperitoneal LP shunts. This is a unique type of shunt which diverts CSF from an area within the spine, not the brain not starting in the brain , called the intrathecal space.
The CSF is diverted into the peritoneal cavity. For more information about the peritoneal cavity, see the VP shunt description above.
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. 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. VP shunts are generally safe, but there are some risks during and after the surgery.
There can be bleeding, or an infection can develop. 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.
Reviewed by: Joseph H. Piatt Jr. According to the University of Chicago , infection is most common in the first few weeks after a shunt placement. Shunting is successful in reducing pressure in the brain in most people.
VP shunts are likely to require replacement after several years, especially in small children. Adults and children over the age of 2 may not need a shunt replacement for eight or more years. Shunt systems require frequent monitoring and follow-up. Complications that may occur with shunt systems include:. Malfunctions can lead to serious complications, such as over- or under-draining of CSF. This can cause ventricles to collapse, which may lead to headaches or hemorrhage inside the brain.
Under-draining allows CSF to accumulate on the brain and can cause symptoms of hydrocephalus to return. Hydrocephalus is a condition that occurs when fluid builds up in the skull and causes the brain to swell.
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Your doctor will…. An anastomosis typically refers to a connection between blood vessels or between two loops of the intestine. Health Conditions Discover Plan Connect. Who needs a VP shunt? VP shunt procedure. Risks of VP shunting. Medically reviewed by Suzanne Falck, M.
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