The Centre of Excellence for Neurosciences at Vimhans Nayati Super Speciality Hospital is managed by a team of the best neurosurgeons in the country specialising in a wide range of cutting-edge procedures and techniques including the placement of VP shunt. Ventriculoperitoneal shunt or VP shunt is a special device that is used to treat hydrocephalus, a condition marked by the accumulation of excessive amounts of fluids in the brain. The shunt consists of two catheters and a valve that help to create a drainage system. The shunt may be placed temporarily or for the rest of the patient’s life. Regular monitoring is also important to ensure that the system is working properly.
VP-shunt can be used to treat hydrocephalus caused by any of the following:
- Severe obstruction that prevents normal cerebrospinal fluid damage
- Excessive production of cerebrospinal fluid
- Improper absorption of cerebrospinal fluid.
Why is VP-Shunt used?
VP-shunt is recommended to patients suffering from hydrocephalus. The condition is marked by unhealthy fluid build-up in the cavities or ventricles of the brain which causes the ventricle to swell up and exert unnecessary pressure and strain on the brain. This pressure can drastically impact the brain tissues and damage them beyond repair, leading to severe disabilities. The problem can affect people of any age group or gender; however, it is much more prevalent in infants and people above 60 years of age. The various symptoms associated with hydrocephalus include:
- Large size of the head
- Evident bulge on the head
- Irritable behaviour
- Poor feeding and vomiting
- Problems with muscle tone and strength
- Poor response to stimuli
- Poor or abnormal growth
Toddlers and adolescents –
- Persistent headaches
- Blurring of vision
- Enlargement of head
- Problems with balance and coordination
- Loss of appetite
- Urinary incontinence
- Behavioural and cognitive changes
- Loss of bladder control
- Inability to remember things or loss of memory
- Loss of reasoning and thinking capacity
- Difficulty with maintaining balance and coordination
How to prepare for the procedure
If you have been recommended to go for the procedure, here are all the things you might be asked to do:
- Cut down on your alcohol intake as the same can interfere with your recovery.
- Refrain from taking Vitamin E
- Do not take any supplement, not even herbal
- Inform your doctors about all the medications that you have been taking as you might need to stop taking these.
- Talking to your doctor about your personal medical history or any other ailment
- Avoid smoking
Various steps involved
The procedure is performed under the influence of general anaesthesia. A small portion of the hair is shaved to clear the area to make the incision. The incision is made carefully. Another incision is made on the patient’s belly. The surgeon will make a small hole in your skull with the help of a surgical drill using imaging guidance. One of the catheters is inserted via this hole and directed towards the affected area i.e. where the fluid has collected.
Another catheter is inserted via a tiny incision made behind the ear and directed towards the belly through the neck and chest. The placement of the catheter in the belly is done with the help of an endoscope. The valve is placed behind the ear and connected to both the catheters.
When there is excessive pressure build-up in the brain, the valve opens and allows the fluid to pass into the stomach where it gets absorbed.
What to expect after the procedure?
After the procedure, it is normal to have a mild headache for a few days which can be managed with the help of simple pain medication. You may not be able to take proper meals for some days and may initially have to take liquid foods.
It is important to keep the incision clean and check for any signs of infection. It is important to consult your doctors before taking shower. Regular health check-ups are also necessary to monitor the drainage system.
Benefits of VP-shunt
The shunt helps to redirect the cerebrospinal fluid to other areas of the body where it can be absorbed easily. It is designed to
- Direct the flow of cerebrospinal fluid
- Regulate the amount of cerebrospinal fluid flowing through the catheter