Shunt Surgery for Hydrocephalus

Gillette Children’s Specialty Healthcare is a regional leader in pediatric neurology and neurosurgery. Our pediatric neurosurgeons treat hydrocephalus—a condition characterized by excessive cerebral spinal fluid in the brain.

Why Choose Gillette?

  • Gillette offers one of the largest teams of pediatric neurologists and neurosurgeons in the Twin Cities.
  • Our pediatric neurosurgery team specializes in the unique needs of people who have hydrocephalus.
  • We offer interdisciplinary, age-appropriate care for people who have hydrocephalus and related conditions, such as spina bifida and cerebral palsy.
  • Our facilities and technology are designed specifically for your needs.
  • We believe that people who have disabilities deserve a lifetime of excellent health care—from birth through adulthood.

Definition and Types of Shunts

There are many causes of hydrocephalus, but treatment generally involves surgical interventions. At Gillette, shunt placement and management is the most common treatment for hydrocephalus. (In some cases, we also offer endoscopic third ventriculostomy.)

A shunt is a flexible plastic tube, about 1/8 inch in diameter, with a valve that controls the flow of cerebral spinal fluid draining from the ventricles of the brain. We most often place shunts in the lateral ventricle, where they can drain to the abdomen (ventriculoperitoneal shunt), the chest (ventriculopleural shunt) or the heart (ventriculoatrial shunt). A fourth type of shunt—lumborperitonel—drains fluid from the lumbar intradural space into the abdomen.

Gillette neurologists most often use ventriculoperitoneal or ventriculoatrial shunts. The shunt systems we use typically include a programmable valve, which can control the rate of drainage without additional surgery.

Ventriculoperitoneal Shunt

A ventriculoperitoneal shunt drains cerebral spinal fluid from the ventricles into the peritoneal cavity (the space in the abdomen that holds the digestive organs, including the stomach and intestines). When cerebral spinal fluid drains into this area, it is absorbed into the bloodstream. Typically, placement of a ventriculoperitoneal shunt involves fewer risks than other types of shunts.

Ventriculoatrial Shunt

A ventriculoatrial shunt runs through a vein in the neck into the right atrium of the heart, where cerebral spinal fluid flows directly into the bloodstream.


What to Expect

Treating hydrocephalus with a shunt involves surgically implanting the shunt, then adjusting and monitoring the shunt regularly.

Implantation

A pediatric neurosurgeon implants the shunt’s tubing, which runs from the brain along the neck, just behind the ear, and down to the drainage area where the excess cerebral spinal fluid is reabsorbed.

Adjusting Shunts

Gillette neurosurgeons use programmable shunts to adjust intracranial pressure without additional surgery. We adjust the valves using a magnetic device held over the patient’s scalp. Most shunt systems also have an access area (usually called a reservoir) that allows doctors to take samples of cerebral spinal fluid using thin needles.

After Implantation

After surgical implantation, all parts of the shunt are under the skin. Except in infants, shunts typically aren’t visible through the skin. After placement of a shunt, the intracranial pressure returns to normal and the size of a child’s ventricles decreases. In infants, the fontanel becomes soft and might appear sunken. The skull sutures will narrow or possibly overlap.

Children whose hydrocephalus was diagnosed and treated early in infancy will have heads similar in size to their peers’. People who have shunts can participate in most day-to-day activities, though they should use caution in rough contact sports.


Complications and Risks

Although shunts typically treat hydrocephalus successfully, patients and their families should watch for signs of possible shunt malfunctions and associated symptoms. They might include:

  • Obstruction. The most common type of complication is an obstruction along the shunt tube. That can happen when, for example, brain or bowel tissue plugs one end of the shunt. Depending on the extent of the obstruction, periodic or continual symptoms of hydrocephalus will return. Shunt obstruction requires immediate medical attention. A neurosurgeon will perform tests to determine the location and degree of a shunt obstruction. The neurosurgeon might need to remove and replace all or part of the shunt system.
  • Infection. As a foreign object inside the body, shunts run a small risk of becoming infected. Signs of infection include redness and swelling along the length of the shunt. To treat an infection, a neurosurgeon will remove the shunt, place a temporary drainage tube and administer antibiotics. Once the infection clears, a neurosurgeon implants a new shunt. Infected shunts occur in less than 5 percent of surgeries and usually become evident within one to six months after surgery.
  • Excess drainage. Shunts can sometimes drain fluid too quickly. That typically happens when patients are standing. It can lead to headaches, vomiting, drowsiness and changes in vision.

Patients and families who notice any sign of complications should contact Gillette immediately.


Lifelong Care

Because hydrocephalus is almost always a lifelong condition, people who have shunts typically need surgeries throughout their lives to replace or repair their shunts. Our medical specialists work with patients and families to educate them on proper shunt maintenance—and on how to observe whether a shunt is working properly.

We offer care for patients whose needs continue into adulthood through Gillette Lifetime Specialty Healthcare.


Collaborative Services

Successfully selecting patients, performing surgery and providing follow-up care requires the collaboration of a highly skilled team. At Gillette, our patients have access to a full range of services and extensive family support. Together, we promote the highest standards of patient care.

Services and specialties most often associated with hydrocephalus shunt treatment include:

For more information about our collaborative services, search Conditions and Care.

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